A swollen leg? Could it be a DVT? This month GP, Alice Fitzgibbon examines Deep Vein Thrombosis.
This month’s column is about DVTs or Deep Vein Thrombosis. Worries about having a DVT often bring people to the GP, but sometimes people also overlook or ignore their symptoms which can be dangerous too.
So, let’s start with the question: what is a DVT? A deep vein thrombosis is when a blood clot forms in one of the deep veins – in the leg this might be in the thigh, the lower leg or higher up towards the pelvis. They can also happen elsewhere in the body.
So why does this happen? A blood clot can form for a number of reasons especially if there is a change in how the blood is able to flow in the vein, if the person has damage to the lining of the blood vessel itself or if they have any medical condition that makes the blood thicker and more likely to form clots.
There are some well recognised factors that make you generally more likely to be at risk of developing a DVT. These risk factors include:
– being over age 60
– being overweight
– being a smoker
– having had a previous DVT
– having cancer
– taking medication containing hormones like the contraceptive pill or hormone replacement therapy.
Some situations also increase risk of DVT developing. These include: if you have been admitted to hospital or had a procedure that had led to reduced mobility, you have been confined to bed, you have been dehydrated, you have travelled on a journey of more than three hours and been sitting still, and lastly during pregnancy or just after giving birth. Sometimes, DVTs can occur without a reason ever being found.
The risk factors above are all the things your doctor will ask about. But what will you have noticed? The signs of a DVT are:
- New swelling of one leg (rarely happens in both)
- Aching or throbbing pain in the leg
- Redness of the skin
- Skin that feels warm to touch
- Swollen veins appearing that can be hard or tender to touch.
If you develop any of these symptoms, as a GP I would like to hear from you on the same day! This is because early recognition of DVT and early treatment can prevent complications. If we see you and suspect you have a DVT, you will be referred for further assessment at a hospital within 24 hours. This will likely include a special blood test called a d-dimer, and an ultrasound scan to look at the veins and check the blood flow in your leg.
Complications of a DVT can include part of the blood clot breaking off and travelling up to the lungs where it can get stuck. This is called a pulmonary embolism. Signs of this might include chest pain, sudden shortness of breath and coughing up blood. If you have any of these signs and a DVT you should seek medical attention immediately via 999 or A&E. This can be a life-threatening emergency.
Treatment for DVT is mostly with blood thinner medications (anti-coagulants). Depending on the cause for the DVT (if there is one found), the length of treatment will vary. Some people may need blood thinners for three months, and for others it might be recommended life-long. Anti-coagulants come in different forms and the medical team would identify the most appropriate one for you. In special cases other more specialised treatments or procedures may be required.
If you are concerned you might have a DVT due to one sided leg swelling, redness and pain then please get it checked out by your GP. Sometimes it doesn’t turn out to be a DVT but – if it is – then prompt assessment and treatment can be arranged to treat the clot and prevent complications.
For further information on Deep Vein Thrombosis (DVT) from the NHS visit https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/