Deep Vein Thrombosis

Deep Vein Thrombosis

Deep vein thrombosis (DVT) or deep vein thrombosis is a blood clot in one or more deep vein blood vessels. In most cases, DVT is formed in the veins of the thigh or calf, but it can also be in the veins of other parts of the body.

A blood clot  is blood that changes from a liquid form to a relatively solid gel through a process called coagulation. When a wound or injury occurs, the blood will clot to stop the bleeding.

In deep vein thrombosis , there is a blood clot in the deep vein that blocks the blood flow. If left untreated, these blood clots can break free and follow the bloodstream, then clog the arteries in the lungs. As a result, the sufferer will have difficulty breathing, and may even experience death.

Causes of Deep Vein Thrombosis

Deep vein thrombosis is caused by a disease or condition that prevents blood from flowing or clotting normally. There are three factors that can cause this, namely:

  • Damage to the veins
  • Disruption of blood flow in the veins
  • Condition of blood that is easier to clot ( hypercoagulability )

Risk factors for deep vein thrombosis

Various diseases or conditions that cause the occurrence of the three factors above can increase the risk of DVT. In other words, a person is more at risk of experiencing deep vein thrombosis if they have the following conditions or diseases:

  • Aged more than 60 years
  • Has a smoking habit
  • Using injectable NAPZA
  • Taking chemotherapy drugs
  • Suffering from genetic abnormalities that cause blood to clot more easily, such as Factor V Leiden , nephrotic syndrome , and antiphospholipid syndrome
  • Taking a long trip by car, car, or plane, which makes the legs not move much
  • Being bedridden, paralyzed, or suffering from a disease that makes the legs immobile for a long time
  • Suffering from a heart attack, heart failure , cancer, intestinal inflammation, overweight , or obesity
  • Having a history of operations on venous blood vessels, such as heart surgery, abdominal surgery, or knee and hip replacement surgery
  • Having a history of injury to the lower body, such as a broken thigh bone, leg bone, or pelvic bone
  • Suffering from diseases that interfere with the function of blood vessels, such as vasculitis and varicose veins
  • Experiencing an increase in estrogen hormone levels, for example due to pregnancy, having just given birth, as well as consuming birth control pills or estrogen hormone replacement drugs
  • Having a history of DVT or pulmonary embolism , both personally and in the family

Symptoms of Deep Vein Thrombosis

In some cases, DVT shows no symptoms at all. However, some complaints that usually appear as a result of DVT can be:

  • Legs with DVT feel warm
  • Pain that worsens when bending the leg
  • Swelling in one of the legs, especially in the calf
  • Cramps that usually start in the calf, especially at night
  • A change in the color of the legs to become pale, red, or darker

When should you go to the doctor?

Immediately see a doctor if you experience the symptoms of DVT that have been mentioned above. If not treated immediately, DVT blood clots can travel to the lungs and cause blood vessels in the lungs to become blocked. This condition is called pulmonary embolism.

Pulmonary embolism is a medical emergency that must be taken care of, with symptoms such as:

  • Coughing blood
  • The pulse felt fast
  • Shortness of breath or sudden shortness of breath
  • Chest pain that worsens when coughing or when taking a long breath
  • Dizziness and feeling faint

Diagnosis of Deep Vein Thrombosis

To diagnose deep vein thrombosis , the doctor will ask the patient's symptoms and disease history. Next, the doctor will perform a physical examination on the part of the body that is sore and swollen.

After that, the doctor will perform a series of supporting examinations, such as:

  • Blood tests Blood
    tests aim to measure the level of D-dimer, which is a protein that is formed when blood clots break down in the bloodstream. A higher level of D-dimer indicates the possibility of DVT in the patient.
  • Doppler
    USG The purpose of the Doppler USG examination is to see if the blood flows normally or is blocked due to blood clots.
  • Venography
    This examination aims to find out where the blood flow is blocked due to blood clots. Venography is an X-ray photo examination performed with the help of injecting a contrast dye into the patient's veins.
  • MRI
    Scanning with MRI is done to get a picture of the venous blood vessels as a whole. This examination can also detect other disorders that may occur in organs around problematic blood vessels.

Treatment of Deep Vein Thrombosis

DVT treatment aims to prevent blood clots from getting bigger, prevent pulmonary embolism, and reduce the risk of DVT recurrence. Treatment methods include:

1. Medicines

Medicines given to DVT patients are anticoagulants , such as heparin and warfarin . This medicine works to prevent blood clots from growing and reduces the risk of new blood clots forming.

If the patient's DVT is severe enough or there is a pulmonary embolism, the doctor will prescribe thrombolytic drugs. This medicine works by breaking up blood clots quickly.

2. Vena cava filter

If the administration of drugs is not effective, the doctor will install a special filter in the blood vessels of the main abdominal cavity ( vena cava ). The filter works to prevent blood clots from entering the lungs and causing pulmonary embolism.

However, it should be known that installing the filter in the long term can actually worsen the condition. Therefore, the filter should be removed after the risk of complications has decreased.

3. Compression stockings

Compression stockings are worn below or above the knee to prevent swelling from DVT. The doctor will advise the patient to wear these compression stockings every day, at least for up to 2 years. The purpose is to reduce the risk of new blood clots forming.

4. Thrombectomy

Thrombectomy is performed if the blood clot is large enough to cause tissue damage. This procedure is done by making a small incision in the blood vessel. After that, the doctor will remove the blood clot, then repair the damaged tissue and blood vessels.

In some cases, the doctor will use a special balloon to keep the blood vessels wide open during the blood clot removal process. After that, the balloon will be lifted with the blood clot.

Complications of Deep Vein Thrombosis

Deep vein thrombosis can cause serious complications, including:

  • Pulmonary embolism , which is the blockage of the arterial blood vessels in the lungs due to blood clots that are released from the limbs
  • Post-thrombotic syndrome (PTS), which is a blood flow disorder in the venous blood vessels due to DVT

Prevention of Deep Vein Thrombosis

Deep vein thrombosis caused by genetic abnormalities cannot be prevented. However, to prevent DVT due to other conditions or diseases, there are several efforts that can be made, namely:

  • If you have just been lying down for a long time, move your legs occasionally or walk if possible to keep the blood flowing smoothly.
  • If you are on a long journey or your job requires you to sit for a long time, do moderate leg movements or occasionally get up from your seat to walk.
  • If you have just undergone an operation, take the anticoagulant medicine prescribed by the doctor so that the risk of blood clots forming after the operation is reduced.
  • Live a healthy lifestyle, such as not smoking, consuming balanced nutritious food , maintaining an ideal body weight, and exercising regularly.
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