Blood clot in the leg (deep vein thrombosis, DVT)

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Last updated:	10-15-2008

Definition and cause

Veins is the system of veins that lead blood back to the heart after it has afiltet in body tissues. On the stand, there are two sets of veins. The deep veins, which run between the muscles, which are not visible, and the superficial veins, which run in under the skin, which often are visible.

A blood clot in a deep vein in the leg is a relatively common condition and can be a serious disorder. It should not be confused with blood clots in superficial veins, there is a much milder condition. There are also substantial differences in blood clots in the legs arteries (arteries) and blood clots in the legs veins.

If there is damage on the inside of a blood vessel, can be deposited fat in karvæggen. The uneven surface of the tank makes blood platelets and red blood cells lump settled here. This process is called in English arteriosclerosis.

Is the blood through depopulation reduced, the platelets also increased tendency to clot together. The formed blood clump of coach called a trigger. When a trigger in the leg will be a certain size, blood can not run from the leg adequately, and symptoms of deep vein thrombosis (DVT).

A blood clot in benets deep veins can be formed for different reasons:

By prolonged bed rental.
After a major surgical procedure (especially ortopædkirurgiske patients).
By tending to arteriosclerosis.
By congenital defects in proteins which prevents blood clots.
By dehydration.
When hormone treatment, including contraceptive pill.
During pregnancy.
In severe heart disease as a myocardial infarction and heart failure.
For certain cancers.
When severe infection.
By disease as systemic lupus erythematosus and polycythemia.

Overweight may have an increased risk of developing deep venetrombe.
A DVT in the leg (often in the groin) occurs frequently after prolonged stillesidden, for example. after a long flight or bus ride.

If the trigger or parts of it, tear themselves loose, which formed a so-calledembolus. This can be conducted with the blood to the heart, where it can be pumped out in the lung arteries and become lodged as a lungembolism.

Deep vein thrombosis is a frequent disorder, and many cases of small blood clots never discovered or misrepresenting as the second disease in the leg. There diagnosed between 5000 and 10,000 cases in Denmark each year, most in women. Has previously had DVT, you have an increased risk of developing a DVT.

Symptoms of blood clot in leg

A deep venetrombe can be completely without symptoms, but often seen following symptoms:

Tension and pain in the leg.
Redness and swelling in the area.
Fever.

The patient may experience increased pain in the doctor when the foot bent upward, but this is not always a specific signs of the disease, and can occur at ordinary muscle soreness.

Precautions and diagnosis

The most important precaution is frequent exercise and avoiding obesity. It is important to avoid prolonged sedentary periods. If you are predisposed to DVT, it is especially important to make frequent venepumpe gymnastics (use benmuskulaturen), and avoid dehydration in the case of long trips and sedentary work.

Women aged over 35 who use the pill should consider some form of contraception, as the risk of DVT associated with contraceptive pill use increases with age. Smoking is strongly associated with arteriosclerosis, why stopping smoking is an important measure.

Have we already had a DVT, or are at risk for it, it's a good idea to use elastic support stockings that can support venepumpen and thus facilitate blood flow to the heart.

Have we suspect a blood clot in the leg and the above symptoms should seek medical advice.

The diagnosis is suspected by the classic symptoms, and possibly. by a history of preceding gone further travel. The doctor will carry out various studies to determine the diagnosis. A blood test can rule out or reinforce the suspicion of DVT.

By the Doppler ultrasound technique, the physician may in many cases diagnose blood clots. In some cases carried out a so-called rickets, which can show deep clots in the leg. Here sprayed a røntgentæt contrast fluid into the veins so that the veins, their flaps, and possibly. jams, can be seen on an X-ray.

Consideration of a blood clot in leg

Treatment aims to avoid that trigger grow and to dissolve it.
Priority will be given so-called anticoagulant medication, which in English is often called blood thinners. This reduces the blood's ability to solidify (clot) and allow the trigger is not growing.

Priority will be given heparin, which is fast-acting, and vitamin K antagonists (eg. Marevan or Marc Oumar), whose effect only occurs after day. Heparin therapy ended when the effect of vitamin K antagonists occurs. This treatment must be put in the minimum 3-6 months and for some life-long.

In each case, you can try to dissolve blood clots by injecting a powerful substance in the blood vein (through a long plastic) very close to blood clots. The treatment is calledthrombolysis. Due. of the high risk of bleeding elsewhere in the body must be given thrombolysis locally (only in a particular area) and there are also many factors that can do that it will not offer thrombolysis treatment. It may, for example. have significant operations in the past few months, or earlier stroke and others. In the case of thrombolysis treatment, the physician may choose to bring a small network of plastic that is unfolding åren, so the blood may flow freely again.

In very rare cases, attempts to drag the whole blood clots out with a catheter and a balloon which was inflated on the other side of blood clots.

Patients with DVT tested for conditions that give tendency to clot, for example. blodstørkningssygdomme congenital or chronic forkammerflimmer in the heart. If such a state, dealt Monday with anticoagulant medication for life.

Select and complications

The most serious complication of DVT is a risk that some of thrombotic river itself loose and migrates with blood flow to the lungs and form a blood clot here called a pulmonary embolism.
It is believed that around. 50% of all deep vein thrombosis resulting in pulmonary embolism, but most are fortunately so small that they do not provide any significant symptoms. A large embolism may provide life-threatening shortness of breath and in the worst cases result in death in a short time.

Blood drains from the leg can become so pronounced that the swelling (edema) in the leg leads to constriction of arteries pulse, so we do not get oxygen to the tissues. This gives vævsdød, and the leg will be blue-black, and due to wounds and blisters (see dry gangræn).

After a blood clot in the leg can cause secondary varicose vein.

Often, veneklapperne after a DVT be damaged and may develop chronic venous insufficiency, which can give more or less genes in the form of swollen ankles, dry scaly authority nor thickened skin, itching, discoloration and skinnebenssår.

About 15% will get a new case of DVT within a period of 5 years from the first time. The vast majority will be completely healthy and live without, or with only a few injury.