Beware of the deep vein thrombus

They say what you don't know won't hurt you, but most of us realise that those are the things that have the best chance to do just that. A deep vein thrombus (DVT) can be a sneaky 'customer'. It's probably no coincidence that it may even resemble a snake!

A deep vein thrombus is a blood clot that forms in one of the deep veins of the body, not the veins on the surface of the body. The most common place is in the leg.

Usually, clots are formed to stop bleeding where one sustains a cut. A DVT is, therefore, like a 'good girl gone bad'. The real danger that a DVT poses is that a piece of it may break free, travel up to the heart then into the lungs and block one of the main arteries there. This may cause sudden death.

CAUSES

So what causes it? There are three factors that contribute to the formation of a DVT:

1. Immobility - The contraction of the muscles in the leg which occur during walking reduces the possibility of clot formation, therefore, lack of movement may contribute to its formation.

2. Trauma to the vein - Damage to the inner surface of the vein can trigger a reaction leading to the formation of a DVT.

3. Hypercoagulability - If the blood itself has an increased risk of forming clots, then this can lead to DVT formation. Often, a combination of these factors may exist in a person at a given time leading to the development of a DVT.

There are many real-life situations that may lead to its formation. These include prolonged travel (Factor 1), hospitalisation (1), obesity (1,3), surgery (1,3), pregnancy (1,3), medications such as birth control pills (3, small risk), smoking (2,3), cancer (1,3), leg injury with or without fractures (2), blood that is excessively thick, and as mentioned last week, non-O blood type.

When a person has a DVT, there may be very little sign of it. However, sometimes it may cause swelling, pain, warmth, and discoloration of the affected leg. The most common way to diagnose it is with a Doppler ultrasound.

Treatment involves using medications that reduces the ability of the blood to clot (anti-coagulants).

Prevention may involve mobilisation, use of anti-coagulants and minimising the other pre-disposing factors.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.