Vein ConditionsDeep Vein Thrombosis (DVT)

When a blood clot (thrombus, or thrombosis) develops in one of the deep veins, it is called a deep venous thrombosis (DVT). DVTs are a serious medical condition and can be life threatening. If the DVT breaks loose from the vein, it can travel through the heart and lodge in the lungs. This is called a pulmonary embolus (PE).

The lower extremities have two venous systems, the deep venous system and the superficial venous system. The deep venous system is vital to the blood flow of the legs, and it is comprised of the common femoral vein, the femoral vein, the deep femoral vein, the popliteal vein, and the tibial veins. The superficial venous system is expendable, and the cause of most varicose vein and spider vein problems. It is comprised of the great saphenous vein, the small saphenous vein, the intersaphenous vein of Giacomini, the anterolateral thigh accessory vein, and the posterior arch accessory vein.

If the DVT totally occludes the popliteal vein, the femoral vein, or the common femoral vein, it can cause severe swelling and pain in the leg. This can lead to a debilitating condition called post thrombotic syndrome.

Risk factors for developing a DVT are cancer, previous DVT, hospitalization, surgery, immobility, hypercoagulable disorders, and advanced age. Many DVTs have no symptoms and are particularly dangerous because the person does not seek treatment. Classic symptoms of a DVT are a painful calf and swollen lower extremity. Chest pain, shortness of breath, rapid heart rate, passing out (syncope), dizziness, pain with a deep breath, and sudden death are signs and symptoms of a pulmonary embolus.

DVT and PE as a group are called venous thromboembolism disease (VTE). VTE is the fourth leading cause of death in the Western world. It is estimated that 600,000 cases of VTE occur every year in the U.S.. Many of these go undiagnosed.

DVT is diagnosed by venous duplex ultrasound. VEINatlanta offers immediate ultrasound examination to rule out DVT. Once an acute DVT is diagnosed, anticoagulation is begun. Typically this can be done as an outpatient. The patient is started on Lovenox (or similar medication) for several days while Coumadin (Warfarin) or another oral medication is started. Anticoagulation is continued for at least 3 months and sometimes much longer. Medical grade compression stockings are also worn for up to two years. This helps prevent post thrombotic syndrome.