Leg Blood Clot (DVT): Warning Signs, Risk Factors and When to Act

What it involves

MedlinePlus defines deep vein thrombosis, or DVT, as a blood clot that forms in a vein deep inside the body. It mainly affects the large veins in the lower leg and thigh, though it can happen in the arms and pelvis, and it most often affects only one side of the body.

Who this is for

• Adults with swelling, warmth or pain in one leg that came on over hours or days
• Patients who recently had surgery, a leg fracture, a long trip or time in bed
• People who take estrogen or birth control pills, smoke or have a family history of clots
• Anyone who has had a clot before and notices similar symptoms

What to expect

• Questions about when the swelling began, which leg is affected and what you have done lately, such as travel, surgery or bed rest
• An exam of the leg for swelling, redness, warmth and tenderness, plus your pulse and breathing
• A same-day plan, which usually means imaging with a Doppler ultrasound and a blood test arranged through referral or the emergency room
• Follow-up care afterward, including medicine review, since blood thinners are managed over months

The warning signs

MedlinePlus says a clot can block blood flow and cause redness of the skin, skin that feels warm to the touch, swelling of a leg or arm, and pain or tenderness in a leg or arm. The key word is one: it most often affects a single side. A calf that is two inches thicker than the other, with soreness that feels like a cramp that will not ease, is a different story from both ankles puffing up at the end of the day, which the leg swelling guide covers.

Who is at higher risk

The encyclopedia lists sitting or bed rest for too long, such as on plane or car trips, recent surgery, most commonly hip, knee or pelvic surgery, fractures of the pelvis or legs, pregnancy or giving birth in the last six months, obesity, a family history of clots, cancer, certain autoimmune disorders such as lupus, cigarette smoking, and taking estrogens or birth control pills. DVT is most common over age 60 but can occur at any age. Several risks together matter more than one on its own.

Why it cannot wait

MedlinePlus explains that when a clot breaks off and moves through the bloodstream, it is called an embolism, and that one that lodges in the lungs, brain or heart can lead to severe damage. Pulmonary embolism is the complication that may be fatal. That is the reason the right move for a suspect leg is a same-day answer, not a wait-and-see week. Our shortness of breath guide and chest pain guide explain the breathing symptoms that follow.

How a clot is confirmed

MedlinePlus says a provider performs a physical exam, which may show a red, swollen or tender leg, and that the tests often done are a D-dimer blood test and a Doppler ultrasound of the affected area, with CT or MRI used for the pelvis or abdomen. Further blood tests may check for conditions that make clotting more likely. Serenity By A Dr. Sareen does not list vascular ultrasound among its in-office services, so these are arranged by referral, and the office will tell you where to go the same day.

Treatment and follow-up

The encyclopedia says treatment is a blood thinner, called an anticoagulant, that keeps more clots from forming or old ones from growing, and that most people can be treated without staying in the hospital. You will most likely take it for at least three months, and some people take it longer. It adds that blood thinners raise the chance of bleeding, so doses and blood tests must follow your provider's directions. Primary care picks up here with medicine reviews, blood work and tracking the cause behind the clot.

Travel and everyday prevention

MedlinePlus advises moving your legs often during long plane trips, car trips and other times when you sit or lie for long periods, taking blood-thinning medicines your provider prescribes, and not smoking. The quitting smoking guide explains where to start. Enlarged surface veins are a different matter from a deep clot, and the varicose veins guide covers them. If you have had a clot before, tell every provider before surgery or a long trip.

Sources

• MedlinePlus: Deep vein thrombosis (medical encyclopedia)
• MedlinePlus: Deep Vein Thrombosis (health topic)