What is deep vein thrombosis or DVT ?
A deep vein thrombosis or DVT is a blood clot which usually develops in the arteries of the legs, but sometimes it can also occur in the arms. Symptoms include: dormant (numb) leg pain, swelling or red leg. If a blood clot (thrombus) in a deep-vein thrombosis disengages results in a pulmonary embolism.
A deep vein thrombosis often occurs in people who have had to stay in bed longer (for example, chronically ill) or that long plane trips. Therefore must be consumed no alcohol at long flights and dehydration are prevented. In addition, regular exercise is important.
DVT can be caused by an abnormality in the blood (coagulation disorder) or overweight. Also, prolonged immobilization (bedridden) and operations (especially the legs) may increase risk. Birth control pills may in women with bleeding disorders increase the risk of DVT. If a DVT occurred in a sibling or parent at a relatively young age, should always be further research.
DVT or Deep vein thrombosis causes
Deep vein thrombosis is a potentially lethal condition. It is jokingly known as the 'economy class syndrome "because the first reports of this disorder were from people on long flights in economy class.
In a large part of the patients the cause of a deep vein thrombosis can be found. However, in a proportion of patients will be able to find any of the above causes. The following factors indicate an increased risk of getting DVT age, bedridden (immobilization), surgery, accident or injury (trauma), cancer, inherited clotting disorders, previous history of thrombosis, deep vein thrombosis in the family, birth control pills, hormone replacement (hormone additional or -Replacement) therapy, pregnancy, obesity, varicose veins, central venous catheters, inflammatory bowel disease and phospholipid syndrome.
Since the beginning of the eighties, the number of diagnoses of deep-vein thrombosis spectacularly increased. The rise is related to the change in diet during that period. Sugary food and carbohydrates in the diet are converted by the body into glucose. High glucose levels in the blood result in the glycosylation of proteins. This is an enzymatic process in which sugar moieties are linked to a protein. The problem is that the glycosylation makes blood stickier which increases the risk of blood clots. Therefore, it is also advisable to reduce the amount of carbohydrates in the diet and to increase the intake of fat and protein. Animal fat contains such as vitamin A, B12 and D have a protective effect on cardiovascular disease. A lack of vitamin B11, and / or a lack of vitamin B6 and B12, can cause cardiovascular disease by a too high level of homocysteine in the blood.
Studies of populations with a diet rich in selenium, fat, protein and low in carbohydrates, such as the Inuit, have shown that Western diseases such as cancer and cardiovascular disease occur much less in such a diet.
Diagnostics
DVT is classically defined by a 2-point ultrasonography. Because the symptoms of deep vein thrombosis or DVT can be quite different, there is a scoring system developed. This scoring system ensures that unnecessarily many people get an echo. The wells score is determined and, together with the determination of the D-dimer in the blood one can do a good prediction whether someone has a thrombosis leg or not. A patient has a Wells score of 2 or more then there is a high suspicion of DVT and there will be an ultrasound of the leg arteries are made. With the 2-point ultrasound, the radiologist can see whether there is a clot in the vessel and whether there is therefore a thrombosis leg. Sometimes the radiologist can also see that no clot in the vessel but that something else is going on in the leg.
Deep vein thrombosis / DVT treatment
The standard treatment for deep vein thrombosis or DVT consists of 3 parts. The first part is to give a good anti-coagulant. This is done by means of injections with low molecular weight heparin for at least 5 days. At the same time there started thrombosis tablets (vitamin K antagonists). These pills should be checked when the thrombosis. Before thrombosis pills are well established, the patient will have to go through with the syringes. These drugs allow the clot does not grow back and that no major clot break free and shoot to the lungs. The thrombosis pills must be used for at least 3-6 months and in consultation with the internist can be chosen to give it longer. One reason to stop anticoagulation tablets that the patient has an excessively high risk of bleeding. One reason to give longer anticoagulation is that the bleeding risk is low and that there is a high risk of recurrence of deep vein thrombosis.
The second part of the treatment is the bandaging of the leg to pull the moisture out. After the moisture is out, the bandage will be replaced by a short compression stocking (compression stocking). The support stocking must have a pressure between 30 and 40mmHg. The compression stocking only needs to reach to the knee. The support stocking must be worn at least 2 years.
The last part of the treatment is to mobilize. Move ensures that the blood flow has to go in the calf, and it activates the body's ability to dissolve the clot. This indicates no increased risk of developing pulmonary emboli.
Deep vein thrombosis / DVT complications
While the risk is low, a pulmonary embolism, there may still occur after the start of the anti-coagulant. Should dyspnea occur, must always be considered a pulmonary embolism there.
In rare cases, the entire leg can be locked. The leg will be heard or blood from the arteries, but the blood can no longer out of the bone, because the vein is completely blocked. In this case, the standard treatment will not be enough, and it will clot acute need to be taken out. The techniques which can then be used are: thrombolysis or thrombectomy.
In the long term, patients may keep many complaints after DVT. How large is the risk that one keeps on complaints, it is depending on the location of the clot. Estimates show that gets between 20 and 50% of the patients suffering from this. These symptoms can vary considerably. It is summarized under the post-thrombotic syndrome (PTS).