Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
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Deep Vein Thrombosis (DVT) is a serious cardiovascular condition where a blood clot forms in a deep vein. These clots usually develop in the calf or thigh, but can also appear in other deep veins, such as those in the arms, pelvis, or abdomen. DVT is a major health concern because it is part of a group of conditions called Venous Thromboembolism (VTE). DVT means a clot has formed in a vein, while Pulmonary Embolism (PE) is when that clot travels to the lungs, which can be life-threatening. At Liv Hospital, we believe that understanding how DVT develops is the first step to preventing and managing it.
The human circulatory system relies on a complex network of veins to return deoxygenated blood to the heart against gravity.
Located just beneath the skin, these veins are visible and help regulate body temperature. When clots form here, the condition is called superficial thrombophlebitis. While painful, these veins do not serve as the primary conduit for blood return and rarely lead to fatal complications.
Deep veins are located within the muscles. Veins like the popliteal, femoral, and iliac are larger and carry about 90 percent of the blood from the legs to the heart. If a clot blocks these veins, it can cause serious congestion and increased pressure.
Normally, blood clots to stop bleeding after an injury. In DVT, however, a clot forms inside a healthy blood vessel when it shouldn’t.
The Coagulation Cascade
Clotting happens through a series of chemical reactions involving proteins called clotting factors. In DVT, these factors turn fibrinogen into fibrin, which forms a mesh that traps blood cells and platelets, creating a solid clot.
Thrombus Propagation
Once a clot starts to form, often behind a valve where blood moves slowly, it can grow larger. The clot may spread along the vein, sometimes moving upward toward the heart and causing more blockage.
Rudolf Virchow, a 19th-century pathologist, identified three primary categories of factors that contribute to thrombosis. This framework remains the gold standard for understanding DVT etiology.
Circulatory Stasis
This means blood flow slows down or pools in one place. Normally, steady blood flow keeps clotting factors spread out and stops platelets from sticking to the vessel wall. When blood moves slowly, such as during immobility, heart failure, or a blockage, the risk of clotting goes up a lot.
Endothelial Injury
The endothelium is the smooth inner layer of a vein. If it gets damaged by surgery, injury, a catheter, or inflammation, the body treats it like a wound and starts the clotting process to repair it.
Hypercoagulability
This means the blood becomes thicker or stickier than normal. It can happen because of genetic changes, hormone shifts, cancer, or severe dehydration.
The severity and management of DVT often depend on the location of the clot within the venous system.
Distal DVT
These clots are located in the calf veins (tibial or peroneal veins) below the knee. They are generally smaller and have a lower risk of breaking off and traveling to the lungs, though they can be painful and may extend upward if untreated.
Proximal DVT
These clots form in the popliteal vein (behind the knee), femoral vein (thigh), or iliac vein (pelvis). Proximal DVTs are considered much more dangerous because of their size and direct path to the lungs.
Upper Extremity DVT
Though less common, clots can form in the deep veins of the arms (brachial, axillary, or subclavian veins). This is often associated with central venous catheters, pacemakers, or extensive weightlifting (Paget-Schroetter syndrome).
The most feared consequence of DVT is when a portion of the thrombus detaches from the vein wall.
Migration
This loose clot, now called an embolus, travels with the blood flow through the heart and into the pulmonary arteries.
Obstruction
Depending on its size, the embolus can block a small lung artery or the main pulmonary artery. This blockage prevents oxygen from entering the blood, leading to potential heart failure and sudden death if not treated immediately.
DVT is not just an acute event; it can leave lasting damage on the venous system.
Valvular Incompetence
The clot can scar the delicate valves inside the vein. Once damaged, these valves cannot prevent blood from flowing backward.
Venous Hypertension
This leads to chronic high pressure in the lower leg veins, resulting in long-term swelling, skin changes, and potentially venous ulcers.
Venous thromboembolism is the third most common cardiovascular illness after heart attack and stroke.
Prevalence Statistics
It affects millions of people globally each year. While it is more common in older adults, it can strike young people, particularly those with genetic predispositions or lifestyle risks.
Preventable Nature
A significant percentage of DVT cases occur during or after hospitalization, making hospital-acquired VTE a primary focus for preventative healthcare strategies at institutions like Liv Hospital.
Healthy veins are elastic and pliable. Understanding DVT highlights the importance of maintaining vascular elasticity through hydration and movement.
The Muscle Pump
The deep veins rely on the contraction of surrounding muscles (especially the calf muscle) to squeeze blood upward. This is why immobility is such a critical factor in the development of DVT.
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A bruise is a collection of blood outside a blood vessel, usually under the skin, caused by trauma. A blood clot in DVT is a solid mass that forms within a blood vessel, blocking blood flow.
No. Superficial phlebitis affects veins near the skin surface and is generally less serious. DVT affects deep veins and carries the risk of pulmonary embolism.
Yes, although it is rare. In children, DVT is usually associated with serious underlying illness, trauma, or the use of central venous catheters for medical treatment.
Over time, the body’s natural mechanisms may dissolve the clot, or it may organize into scar tissue within the vein, which can permanently narrow the vessel.
It is named “deep” because it affects the deep venous system, which is located deep inside the body’s muscle compartments, as opposed to the superficial veins visible under the skin.
Buerger’s disease, also known as thromboangiitis obliterans, is a rare condition. It’s mainly caused by tobacco use. It harms the small and medium-sized arteries and
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