Deep vein thrombosis or DVT describes a blood clot (thrombosis) that forms in the deep veins located in the arm or leg. It is important to know the body’s anatomy and function to understand why clots form in veins and why they can be dangerous.
Thank you for reading this post, don't forget to subscribe!⇒Arteries have thin muscles within their walls to be able to withstand the pressure of the heart pumping blood to the far reaches of the body. Veins don’t have a significant muscle lining, and there is nothing pumping blood back to the heart except physiology. Blood returns to the heart because the body’s large muscles squeeze the veins as they contract in their normal activity of moving the body. The normal activities of moving the body returns the blood back to the heart. Being mobile causes this blood return system to fail, and the resulting stagnated blood may clot.
⇒There are two types of veins in the arm or leg; superficial veins and deep veins. Superficial veins lie just below the skin and are easily seen on the surface. Deep veins, as their name implies, are located deep within the muscles of the extremity. Blood flows from the superficial veins into the deep venous system through small perforator veins. Superficial and perforator veins have one-way valves within them that allow blood to flow only in the direction of the heart when the veins are squeezed.
⇒A blood clot (thrombus) in the deep venous system of the leg or arm, in itself, is not dangerous. It becomes potentially life threatening when a piece of the blood clot breaks off and embolizes, travels through the circulation system through the heart, and enters into one of the pulmonary arteries and becomes lodged. This can prevent blood from flowing properly through the lung and decreasing the amount of oxygen absorbed and distributed back to the body.
⇒Diagnosis and treatment of a DVT is meant to prevent pulmonary embolism.
⇒Blood clots in the superficial veins do not pose a danger of causing pulmonary emboli because the perforator vein valves act as a sieve to prevent clots from entering the deep venous system. They are usually not at risk of causing pulmonary embolism.
⇒There are both superficial and deep veins in the limbs or extremities (arms and legs). A blood clot in the deep veins is a concern because it can cause life-threatening complications.
⇒A blood clot (thrombus) in the deep venous system of the leg becomes dangerous if a piece of the blood clot breaks off or travels through the bloodstream, through the heart, and into the pulmonary arteries forming a pulmonary embolism. A person may not have signs or symptoms of a small pulmonary embolism (blood clot in the lungs), but a large embolism can be fatal.
How do a person get deep vein thrombosis?
Blood is meant to flow. If it becomes stagnant, there is a potential for it to clot. The blood in veins constantly forms microscopic clots that are routinely broken down by the body. If the balance of clot formation and clot breakdown is altered, significant clotting may occur. A thrombus can form if one or a combination of the following situations.
Immobility
- Prolonged travel and sitting, such as long airplane flights (“economy class syndrome”), car, or train travel
- Hospitalization
- Surgery
- Trauma to the lower leg with or without surgery or casting
- Pregnancy, including 6-8 weeks after delivery of the baby
- Obesity
Coagulation of the blood faster than usual (hypercoagulation)
- Medications such as birth control pills (oral contraceptives), for example, Ortho-Novum, Yaz, Yasmin, Microgestin, Kelnor, and other estrogens
- Smoking
- Genetic or hereditary predisposition to clot formation
- Increased number of red blood cells (Polycythemia)
- Cancer
- Trauma to the vein
- Fracture to the leg or arm
- Bruised leg or arm
- Complication of an invasive procedure of the vein
Risk Factors for Deep Vein Thrombosis or DVT
Risk factors for blood clot formation include immobility, a genetic tendency toward blood clotting, and injury to veins or adjacent tissues occurs.
There are other types of thrombosis such as:
-
- Cerebral venous thrombosis (CVT)
- Portal vein thrombosis
- Cavernous sinus thrombosis
Deep Vein Thrombosis or DVT Symptoms & Signs
Symptoms of deep vein thrombosis (DVT) occur when there is a blood clot in one of the deep veins (vessels that return blood to the heart after it has delivered oxygen to the tissues). Most commonly, deep vein thrombosis occurs in a vein of the leg, but it can also occur in other locations such as the pelvis. The most serious complication of deep vein thrombosis is pulmonary embolism, in which a blood clot breaks off of the DVT and travels through the bloodstream and becomes lodged in a blood vessel of the lung. Symptoms of DVT involve the overlying skin and include
- redness,
- warmth,
- Swelling
- tenderness,
- Pain,
- Leg cramps, often starting in the calf,
- Leg pain that worsens when bending the foot,
- Bluish or whitish skin discoloration.
The involved vein can sometimes be felt as a rough or thick cord beneath the skin. The location of the symptoms depends on the location of the blood clot. It is possible for a DVT to occur without causing specific symptoms.
Causes of deep vein thrombosis or DVT
There are many factors that can cause a blood clot in a deep vein. These include immobility of the leg, such as occurs with long airplane flights, hospitalization, or following surgery. Trauma to the lower leg also increases the risk, along with pregnancy and obesity. Conditions in which the blood is more likely than normal to clot (hypercoagulability) also increase the chance of deep vein thrombosis. Certain medications, smoking, and some medical conditions can increase the likelihood of the blood to clot.
Other deep vein thrombosis (dvt) symptoms and signs
- Arm Swelling
- Calf Pain
- Foot Pain
- Leg Pain
- Leg Swelling
- Lump Beneath Skin
- Redness of Skin
- Tenderness
- Warmth
Signs and symptoms of superficial blood clots
Blood clots in the superficial vein system (closer to the surface of the skin), most often occur due to trauma to the vein, which causes a small blood clot to form. Inflammation of the vein and surrounding skin causes the symptoms similar to any other type of inflammation, for example,
- Redness
- Warmth
- Tenderness
- Swelling
Patient often can feel the vein as a firm, thickened cord. There may be inflammation that follows the course of part of the leg vein. Although there is inflammation, there is no infection.
Varicosities can predispose to superficial thrombophlebitis and varicose veins. This occurs when the valves of the larger veins in the superficial system fail (the greater and lesser saphenous veins), which allows blood to back up and cause the veins to swell and become distorted or tortuous. The valves fail when veins lose their elasticity and stretch. This can be due to age, prolonged standing, obesity, pregnancy, and genetic factors.
Diagnose deep vein thrombosis or DVT
The diagnosis of superficial thrombophlebitis usually is made at the bedside of the patient, based upon history, potential risk factors present, and findings from the physical examination. Further risk stratification tools may include scoring systems that can help decide whether a DVT is likely.
If the probability of a leg thrombosis is low, a D-Dimer blood test may be ordered.
- If the D-Dimer is negative, then it is unlikely that a DVT is the diagnosis.
- If the D-dimer is elevated, then the possibility of a DVT exists and an imaging study, usually ultrasound, is required to look for the DVT
Ultrasound
- Ultrasound is the standard method of diagnosing the presence of a deep vein thrombosis.
- The ultrasound technician may be able to determine whether a clot exists, where it is located in the leg or arm, and how large it is. It also may be possible to know whether the blood clot is new or chronic. If necessary, ultrasounds may be compared over time to see whether a clot has grown or resolved.
- Ultrasound is better at “seeing” the veins above the knee as compared to the small veins below the knee joint.
- Clots in the chest or pelvis may not be identified on ultrasound.
D-Dimer
D-Dimer is a blood test that may be used as a screening test to determine if a blood clot exists. D-Dimer is a chemical that is produced when a blood clot in the body gradually dissolves. The test is used as a positive or negative indicator. If the result is negative, then in most cases no blood clot exists. If the D-Dimer test is positive, it does not necessarily mean that a deep vein thrombosis is present since many situations will have an expected positive result. Any bruise or blood clot will result in a positive D-Dimer result (for example, from surgery, a fall, in cancer or in pregnancy). For that reason, D-Dimer testing must be used selectively.
Venography
Venography, injecting dye into the veins to look for a thrombus, is not usually performed anymore and has become more of a historical footnote.
Other blood testing may be considered based on the potential cause for the deep vein thrombosis.
Allopathic treatment and management for deep vein thrombosis or DVT
The allopathic treatment for deep venous thrombosis is anticoagulation or “thinning the blood” with
medications.
The recommended length of allopathic treatment for an uncomplicated DVT is three months. Depending upon the patient’s situation, underlying medical conditions, and the reason for developing a blood clot, a longer duration of anticoagulation may be required. At three months, the doctor or other health care professional should evaluate the patient in regard to the potential for future blood clot formation.
If the decision is made to continue with anticoagulation therapy for the long term, the risk/reward for preventing clots versus bleeding risks should be evaluated by a doctor.
Allopathic treatment of superficial blood clots
Allopathic treatment for superficial thrombophlebitis treating the symptoms with:
- Warm compresses
- Leg compression
- Anti-inflammatory medications such as ibuprofen or naproxen.
If the thrombophlebitis occurs near the groin where the superficial and deep systems join together, there is potential that the thrombus could extend into the deep venous system. These patients may require anticoagulation or blood thinning drugs for rest of life.
Allopathic anticoagulation prevents further growth of the blood clot and prevents it from forming an embolus that can travel to the lung. The body has a complex mechanism to form blood clots to help repair blood vessel damage. There is a clotting cascade with numerous blood factors that have to be activated for a clot to form.
There are different types of allopathic medications that can be used for anticoagulation to treat DVT:
- Unfractionated heparin
- Low molecular weight heparin: enoxaparin
- Novel oral anticoagulants (NOACs) also known as direct oral anticoagulants (DOACs)
- Warfarin.
Some Physicians has guidelines that give direction as to what medications might best be used in different situations. For example, a patient with a DVT, and no active cancer, treatment with a NOAC would be recommended. If active cancer exists, the treatment of DVT would be with enoxaparin as the drug of first choice.
Novel oral anticoagulants (NOACs) work almost immediately to thin the blood and anticoagulate the patient. There is no need for blood tests to monitor dosing. The NOAC medications presently approved for deep vein thrombosis treatment include:
- apixaban
- rivaroxaban
- edoxaban
- dabigatran.
All four are also indicated to treat pulmonary embolism. They also may be prescribed to patients’ anticoagulated with nonvalvular atrial fibrillation to prevent stroke and systemic embolism.
Side effects and risks of allopathic anticoagulation therapy
Patients who take anticoagulation medications are at risk for bleeding from any orifice and/or any organ. The decision to use these medications must balance the risk and rewards of the treatment. Should bleeding occur, there are strategies available to reverse the anticoagulant effects.
Patients who are contraindications to anticoagulation therapy, for example a patient with bleeding in the brain, major trauma, or recent significant surgery, hematuria (blood in urine), kidney failure, hemorrhoids/piles, open wounds, cancers etc. An alternative may be to place a filter in the inferior vena cava (the major vein that collects blood from both legs) to prevent emboli, should they arise, from reaching the heart and lungs. These filters may be effective but have the potential risk of being the source of new clot formation ????????. An IVC filter is NOT recommended for patients who are also taking anticoagulation medications.
Surgery for Deep vein thrombosis or DVT 
Surgery is a rare option in allopathic treating large deep venous thrombosis of the leg in patients who cannot take blood thinners or who have developed recurrent blood clots while on anticoagulant drugs. The surgery is usually accompanied by placing an IVC (inferior vena cava) filter to prevent future clots from embolizing to the lung.
Phlegmasia Cerulea Dolens describes a situation in which a blood clot forms in the iliac vein of the pelvis and the femoral vein of the leg, obstructing almost all blood return and compromising blood supply to the leg. In this case, surgery may be considered to remove the clot, but the patient will also require anticoagulant medications. Stents may also be required to keep a vein open and prevent clotting. May Turner syndrome, also known as iliac vein compression syndrome, is a cause of phlegmasia, in which the iliac vein in the pelvis is compressed and a stent is needed.
Complications with allopathic treatment
Pulmonary embolism is the major complication of deep vein thrombosis. With signs and symptoms such as chest pain and shortness of breath, it is a life-threatening condition. Most often pulmonary emboli arise from the legs.
Post-phlebitic syndrome can occur after a deep vein thrombosis. The affected leg or arm can become chronically swollen and painful with skin color changes and ulcer formation around the foot and ankle.
Homeopathic Treatment of Deep vein thrombosis or DVT
Apis Mellifica
Abscess. Ankles, swelling of. Apoplexy. Dissection wounds. Dropsy. Ear, erysipelas of. Erysipelas. Erythema nodosum. Eyes, affections of; optic neuritis. Feet, burning of. Gangrene. Gout. Hands, swelling of. Heart, affections of. Heat-spots. Housemaid’s knee. Hydrocephalus. Hydrothorax. Injuries. synovitis. Meningitis. Ovaries pain in; inflammation of; tumours of. Panaritium. Pannus. Peritonitis. Phlebitis. Hydrothorax. Sensation of soreness in the chest, as from a bruise. Oppression of the chest, shortness of breath especially when ascending; inability to remain in a warm room. Dull aching pain in chest. Expectoration of copious, transparent, frothy, bloody mucus. Every shock from coughing gives pain in the head and some pain through the chest. Sudden pain just below the heart, soon extending toward. violent beats, shaking the whole body; intermittent beats. Region of heart sensitive to least pressure; rasping sounds of systole and diastole unmistakably audible. Palpitation of heart from scanty secretion of urine, perfectly cured by establishing the natural quantity. Pulse: almost imperceptible at wrist; accelerated and full; very frequent and hard; wiry; irregular and slow pulse; intermittent.
Arnica
Dry, short cough, produced by a titillation in the larynx. Cough with bloodshot eyes, or nose-bleed. Even yawning provokes a cough. Hemoptysis (Cough with expectoration of blood); the blood is clear, frothy, mixed with coagulated masses and mucus. On coughing, shooting pains in the head, or a bruise-like pain in the chest. Respiration short, panting, difficult, and anxious. Rattling in the chest. Shootings in the chest and sides, with difficulty of respiration, aggravated by coughing, but breathing deeply, and by movement; better from external pressure. Beating, and palpitation of the heart. veins of hands swollen, purplish; sudden pain as if heart squeezed or had got a shock (angina pectoris). Heart strained; irritable; stitches in.
Secale Cornutum
Heavy, anxious breathing, with moaning.-Spitting of blood, with or without cough. Feeble voice, inaudible, stammering. Expectoration of blood during violent efforts to breathe. Anxious and obstructed respiration, with sighs and sobs. Dyspnoea and oppression of chest. Suffocating oppression of chest, with cramp in diaphragm. Praecordial tenderness. Painful sensation over heart. Praecordial anxiety. Violent spasmodic palpitation. Pulse small, very rapid, contracted; frequently intermittent; fluttering, slow, depressed.
Phosphorus
Cough excited by a tickling and itching in chest. -Hollow, hacking, spasmodic, tickling cough, especially if caused by tickling in chest. Cough with stitches over one eye. Dry, shaking cough, with sensation as if head were going to burst. Cough in paroxysms, brings up a viscid, muco-purulent expectoration, branched like the bronchial tubes, pale red, rust-coloured, streaked with blood. Noisy and panting respiration. Difficult respiration. Respiration oppressed, quick, anxious. Spasmodic asthma. Constrictive spasms in chest. After a cough, asthma. Fits of suffocation. Rush of blood to heart and palpitation, that becomes very violent after eating. Palpitation of heart of different kinds, especially after a meal, morning and evening, when seated and after all kinds of mental excitement. Palpitation of heart with obstructed respiration; palpitation from every mental emotion. Violent palpitation with anxiety, evenings and mornings in bed; on slight motion. Blowing sounds in heart. Pressure in middle of sternum and about heart. Pulse rapid, full, and hard; small, weak, easily compressed.
Carduus Marianus
Irritation in posterior part of larynx causing cough. Expectoration: pure blood; mucus mixed with blood. Drawing pain under ribs. Pain during breathing. Cough with stitches in sides of chest and bloody sputum. Splenic or hepatic cough. Pains in chest, going to front part, to shoulders, back, loins, and abdomen combined with urging to urinate. Pain pressure and stitches in region of heart; oppression on deep breathing.
Salicylicum Acidum
Respiration hurried, sometimes deepened, sometimes shallow or sighing and almost panting, as if laboured, but no complaint of difficulty of breathing.-Dry cough of a hard, racking, spasmodic character. Spasmodic, flatulent asthma; fetid bronchitis; gangrene of lungs. Pulse small, rapid, weak.
Bothrops Lanceolatus
Haemorrhages, the blood being fluid and black. Pulmonary congestion, oppressed breathing and bloody expectoration, more or less profuse. Paralysis of arm or leg. Deep gangrene, bones laid bare and necrotic. Hemiplegia. Dissecting gangrene. Slight shivering followed by very profuse cold sweat.
Convallaria Majalis
Fluttering at heart, lasting about a minute, then face would get red, with sensation as if heart stopped beating and would start again very suddenly, with faint, sick feeling.-Pulse full, compressible, intermittent. Pulmonary congestion. Orthopnea. Dyspnoea while walking. Endocarditis, with extreme orthopnea. Sensation as if heart ceased beating. Angina pectoris. Extremely rapid and irregular pulse.
Naja
Short, puffing cough, every minute. Dry, hacking cough; blood-spitting. Expectoration of whitish viscid mucus. Spitting of blood. Respiration very slow; shallow, and scarcely perceptible; laboured and difficult; gasping for breath. Heavy pain in chest. Lancinating pains, feels better on deep inspiration. Asthmatic constriction of chest; cannot expand lungs; followed by mucus expectoration. Heavy pain over lower half of chest, with stabbing on deep inspiration; cannot cough for the stabbing. Dull pain of sternum. Tenderness over sternum. Feeling of depression and uneasiness about heart. Severe pain in region of heart. Fluttering and palpitation of heart. Audible heart beating. Pulse slow and irregular in rhythm and force; weak and thready, scarcely perceptible. Pulse rapid; and full; 120, some beats tolerably full and strong, afterwards 32, irregular in rhythm and force, some of the beats full and bounding.
Belladonna
Cough with stitches in the chest, in the lumbar region, in the hip, in the uterus; pain in the sternum, with tightness of the chest; with rattling of mucus on the chest. Dry spasmodic cough, with vomiturition. Whooping-cough, with crying, or pain in the stomach before the attack, with expectoration of blood (pale or coagulated), congestion of blood to the head, sparks before the eyes, spasms in the throat, bleeding from the nose, stitches in the spleen, involuntary stool and urine, oppressed breathing, stiffness of the limbs, shaking of the whole body, and dry general heat. Breathing laboured, unequal, quick, with moaning. Rattling noise, and crepitation in the branchia. Vehement expirations. Feeling of suffocation when swallowing, or when touching and turning the neck. Oppression of the chest, difficult respiration, dyspnoea and shortness of breath, sometimes with anxiety. Congestion to the chest. Irregular respiration, at one time small and rapid, at another time slow and profound. Respiration short, anxious, and rapid. Violent beatings of the heart. Trembling of the heart, with anguish and pressive pain.
Vipera communis
Suffocation. Dyspnoea; with sticking in heart. Anxious breathing, threatening asphyxia. Breathing ceased suddenly, heart stopped, face became livid. Blood drawn from arm flowed scantily, was dark, mixed with bright streaks. Veins of chest and abdomen thick and hard. Swelling of chest and/or umbilicus. -Edema of lungs before death. Pain in chest; over the ribs on pressure. Oppression, with anxiety; with violent efforts to breathe and swallow.
Sticking in heart; with cold sweat and faintness. Pain in heart with faintness. Dragging pain, becomes faint. Anxiety. Heart’s action: slow; feeble; and no pulsation in radial or carotid arteries, but that in crural was very strong. Pulse: rapid; interrupted; slow, febrile; irregular; weak. Vipera is a very valuable medicine for varicose veins and for acute phlebitis, the vein is swollen, bordered by an area of inflammation, very sensitive to touch, but particularly with the sensation, on letting the leg hang down, as if it would burst from the fulness of the veins.
Aesculus Hippcostanum
Short cough, increased by swallowing and breathing deeply. Hoarseness. Raw feeling in chest. Tightness in chest. Abundant raising of mucus in morning. Cough, with sensation of stiffness in the throat and suffocation in the upper chest. Oppression, stitches, soreness and other troubles of chest. Catarrhal affections causing hoarseness and cough. Twitching over region of heart. Stitches and neuralgic pains in region of heart and forehead. Functional disturbances of the heart from haemorrhoidal complaints.
Hamamelis Virginica
Tickling cough, taste of blood on awaking. Dry cough, severe stinging in the uvula, as if it would break. Expectoration thick, yellowish or greenish grey, tasting putrid. Haemoptysis (tickling cough with blood). Tightness of the chest; cannot lie down, because of difficult breathing from congestion; fullness in the head. Stitches in lower part of lungs.-Sensation of constriction across chest. Palpitation. Pricking pain in region of heart and superficial veins of both arms.
Aurum Metallicum
Accumulation of mucus in the trachea and in the chest, which is expectorated with difficulty in the morning. Voice nasal. Cough from want of breath at night. Cough with tough yellow sputum on awaking. Great difficulty of respiration, requiring deep inspirations. Paroxysms of suffocation, with constrictive oppression of the chest, falling, loss of sense, and bluish colour of the face. Pain, as if there were a plug placed under the ribs. Continuous aching in the chest. Incisive pain, and obtuse shootings, near the sternum. Great weight on chest. Much congestion in the chest.
Anxious heart palpitation, from congestion to the chest. Beatings of the heart, irregular, or by fits, sometimes with anguish and oppression of the chest. Pain in heart region extending down arm/to fingers. Floundering heart. When walking, the heart seems to shake as if it were loose. Sensation as if the heart stood still. Palpitation compels patient to stop.
Lachesis
Catarrh, with cough, coryza, shooting pains in head, stiffness of nape of neck, and affection of chest. Oppressed breathing. Sensation of pulsation and of choking between larynx and chest. Cough with rawness of chest, difficult expectoration. Frequent attacks of short cough from tickling in pit of stomach. Haemoptysis. Respiration short, frequent, or convulsive or rattling, stertorous, and croaking, or wheezing, moaning, and deep. Frequent want to draw a long breath. Dyspnoea and oppression of the chest, with effort to breathe. Shortness of breath. Fits of suffocation. Paralytic orthopnoea. Offensive slow, heavy, wheezing breathing. Extravasation of blood in lungs. Pneumonia. Gangrene of lungs. Swelling and bloatedness of integuments of chest. Itching, red places, and miliary eruption on chest.
Palpitation of heart and choking from slightest anxiety. Irregularity of beats. disagreeable pulsation in ears. Stitches in region of heart, with shortness of breath, fainting fits and cold sweat.
Secal Cornutum
Heavy, anxious breathing, with moaning.-Spitting of blood. Expectoration of blood during violent efforts to breathe. Anxious and obstructed respiration, with sighs and sobs. Dyspnoea and oppression of chest. Suffocating oppression of chest, with cramp in diaphragm. Praecordial tenderness. Painful sensation over heart. Praecordial anxiety. Violent spasmodic palpitation of heart. Pulse small, very rapid, contracted; frequently intermittent; fluttering, slow, depressed.
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