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Deep Vein Thrombosis
27 Jan' 21

Deep Vein Thrombosis

 


When a cut is sealed, blood clots can save your life. When they form inside an artery or vein, they can be hazardous, even fatal. The formation of a blood clot in a big leg vein is known as deep vein thrombosis (DVT). It can also happen in a vein in the arm. A pulmonary embolism or a stroke can occur as a result of deep vein thrombosis. 

On its way back to the heart, blood that has traveled to the legs and feet must flow against gravity. The trip is helped by leg muscular contractions while walking or fidgeting. The contractions pinch the veins and force blood to flow through them. Inside the veins, little flaps or valves keep blood flowing in the direction of the heart.  

Anything that causes blood flow to slow in the arms and legs can lead to the formation of a blood clot. This can range from having an arm or leg immobilized in a cast to being confined to bed for long periods. Deep-vein thrombosis can also be triggered by factors that make blood more susceptible to clots, such as genetic diseases and cancer. 

 

Deep vein thrombosis and pulmonary embolism symptoms  

Deep vein thrombosis can strike without warning. It can also result in:  

  • pain or tenderness in a leg or arm that gets worse with time, not better 
  • swelling in one leg or arm 
  • a reddish or bluish hue to the skin of one leg or arm  
  • a leg or arm that feels heated to the touch  

 

The following are some of the signs and symptoms of pulmonary embolism:  

  •  breathing problems  
  • a rapid heart rate chest ache or discomfort that worsens with a strong breath or cough coughing up blood  
  • lightheadedness or fainting that occurs suddenly 

 

Diagnosing pulmonary embolism and deep vein thrombosis  

Your doctor will evaluate your legs for swelling and pain to determine DVT. He or she will inquire about your signs and symptoms, as well as your risk factors.  

Your doctor may prescribe a D-Dimer blood test or an ultrasound of your legs based on the results.  

D-Dimer is a substance that is measured by a blood test. When blood clots are actively developing in the body, it is virtually always abnormally high.  

An ultrasound of your legs is performed to check for abnormalities with blood flow in your veins. The method is known as a LENI (lower extremity non-invasive test). Your doctor will diagnose DVT if the LENI reveals indications of a blood clot. 

It's important to note that just because the LENI is negative doesn't indicate there isn't a clot. It's possible that the full impact of the clot will not be seen for some time. Your doctor could urge you to come back in three to four days for another LENI.  

If your doctor fears you have a pulmonary embolism, the first thing he or she will do is rule out DVT. If you have symptoms of a pulmonary embolism and the LENI indicates one or more blood clots in your leg veins, an embolism is the most likely diagnosis.  

Alternatively, your doctor may request a chest computed tomography (CT) scan. A dye injection is given intravenously to examine for blood clots in the pulmonary arteries. 

  

Treating Deep vein thrombosis   

Heparin or one of the newer oral anticoagulant medications is the first line of treatment for a DVT or pulmonary embolism. These drugs work by inhibiting the production of new blood clots and so allowing undesirable clots to shrink. "Blood thinners" is a frequent term for them.  

Heparin is divided into two categories. A steady intravenous infusion is the best way to provide the oldest form of heparin. Low-molecular-weight heparin is another form of heparin. Once or twice a day, it is injected under the skin.   

Rivaroxaban (Xarelto) and apixaban (Eliquis) are two newer anticoagulant medications that have been licensed for the initial treatment of DVT and pulmonary embolism. 

Some people may require hospitalization to begin treatment. Many factors influence the type of heparin utilized in this circumstance. Bodyweight, kidney function, and other factors are among them.  

If you suffer a pulmonary embolism, you will almost certainly be admitted to the hospital. If this is the case, you will most likely be given either form of heparin at first. If your pulmonary embolism is minor, oral rivaroxaban or apixaban may be used instead of heparin.  

Your doctor will switch you from intravenous heparin to low-molecular-weight heparin shots under the skin to oral heparin. Warfarin has been the standard oral medication for many years (Coumadin). It was the only oral medication that could cure DVT and pulmonary embolism for decades. 

In addition to rivaroxaban and apixaban, dabigatran (Pradaxa) and edoxaban are two more oral anti-coagulant medicines that can be administered following heparin (Savaysa). More of these medications will be approved soon.  

It takes a few days for warfarin to start working. You will cease taking heparin after a blood test confirms that warfarin is effective. You'll be on warfarin for several months, if not longer.  

You'll need frequent blood tests for the first few weeks while on warfarin to make sure you're getting the proper dose. Blood can be drawn every two to four weeks once your blood test results consistently show that you are taking the correct dosage of medicine. 

Warfarin's blood-thinning activity can be influenced by certain meals, particularly green, leafy vegetables high in vitamin K. Request a list of these foods from your doctor or pharmacist. You can eat these foods indefinitely as long as you eat roughly the same quantity each day. That way, the medication's effect will be consistent.  

Warfarin's effectiveness in your body can be influenced by other drugs. You should inform any doctor who is prescribing you medication that you are taking warfarin.  

Regular blood testing is not required with the new innovative oral anti-coagulants. They're given in a set amount. Another benefit is that you won't have to worry about consuming too much vitamin K-rich food. 

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