- Deep vein thrombosis is a clot in deep veins generally and most significantly in the legs. The veins are deep in the legs and cannot be seen or felt.
- SVT- Superficial Vein Thrombosis- Phlebitis (inflammation) and clots in the veins close to the skin. Can often be felt except in overweight or obese patients. Often tender and firm and frequently the overlying skin is pink.
DVT can be dangerous or have long term complications. SVT doesn’t have significant consequences other than short term discomfort and possible long term varicose veins.
What causes it?
The causes of DVT and SVT are:
- Inherited pre-disposition to clot- Thrombophilia
- Inactivity--long trips without movement
- Hospitalization with bed rest
- Obese patients with inactivity
- Operation--especially orthopedic (back, hip and knee), pelvic and abdominal, and neurosurgical (brain) with bed rest
- Trauma--injury to vessels or surrounding tissue with swelling
- Cancer and blood disorders with “thickened” blood
- Dehydration
How significant is it?
DVT affects millions of people each year. 60,000 people die each year from clots in the deep veins usually above the knee which break off and are thrown to the lung (Pulmonary Embolus) not allowing the blood to oxygenate. This can be fatal. Two-thirds occur in the hospital or after discharge.
It is often called the "silent" killer because clots are frequently unsuspected and asymptomatic especially if one is on bed rest. In one-third of cases there is persistent blockage of the vein and /or destruction of the valves. This can lead to post-phlebitic syndrome which can cause slow destruction of the skin and underlying fatty tissue and eventually lead to an ulcer.
What are the symptoms?
If a person gets a clot while on a trip or in a situation where the legs are down, the clot can be "silent" but usually will cause a dull, aching, throbbing sensation and be accompanied by swelling, especially when the legs are down.
How is it diagnosed?
DVT- Pain and swelling cause suspicion but aren’t diagnostic. The diagnosis is made by a Doppler ultrasound examination that is done by an experienced technician.
SVT- The diagnosis can be made on physical exam. The clotted vein is often felt as a firm cord which is tender and may have an overlying pink color on the skin. This is inflammation not infection. The cord and tenderness may last for several weeks. SVT is sometimes referred to as phlebitis, which means inflamed vein, and a Doppler ultrasound test should be performed if possible since 20-25% of the time there is an associated DVT.
How is it treated?
DVT- Blood thinners such as Heparin and Coumadin are routinely used to treat a DVT. Heparin is given under the skin by injection for 4-5 days. Coumadin, a pill, is started at the same time and continued for several months. If the clot has occurred before, if there is a history of several previous episodes or a family history of clots, a thrombophilia work up is performed to check for abnormal clotting.
Compression stockings not only control swelling, but also help to resolve the blood clot. It is important to stay as active as possible while avoiding swelling.
SVT- The area of involvement can be treated with warm or cold compresses. Anti-inflammatory medications should be considered. Antibiotics should generally be avoided--this is inflammation, not infection or blood poisoning. Blood thinners are generally not used unless the clots spread. Compression stockings should be worn if possible.
How can I prevent DVT or SVT?
- Keep legs and feet active when in sedentary positions for long periods
- Keep well hydrated, especially when traveling
- Wear compression stockings while traveling
- Avoid constricting garments especially if overweight or obese, or when traveling
- On a long term basis, exercise frequently, avoid obesity
- Quit Smoking
If a suspicion of DVT or if SVT is found, you should see a specialist for a definitive diagnosis and treatment. Contact Vascular Vein Centers for a Priority Consultation by one of our specialists. Vascular Vein Centers is Central Florida’s leader dedicated to leg health.
Get up, get out, keep moving and wear your compression stockings for healthy beautiful legs.
