If you have any concerns please read this collection of frequently asked questions before contacting us. If you are still unclear about something feel free to contact.
Thrombosis is another word for blood clot. Deep vein thrombosis (DVT) refers to the formation of a blood clot in one of the deep veins of the body, usually a vein in one leg (77%) or both legs (12%), but DVT can also occur in the arms (11%) or at an usual site (<1%) e.g. liver, brain, uterus veins, etc. The symptoms of a DVT in the leg or arm are: persistent pain in the arm or leg that doesn’t get better, swelling of your arm or leg, redness or change in colour in your arm or leg, new or sudden warmth in your arm or leg.
The chances of developing DVT are about 1 in 1000 per year, although certain factors such as cancer, major surgery and being confined to bed for a lengthy period of time greatly increase the risk.
Superficial vein thrombosis (SVT) is also called superficial thrombophlebitis. Symptoms include pain, swelling and redness along the length of a superficial vein. These veins are not in the deep system and do not carry blood directly back to the heart and lungs, but instead transfer blood into the deep veins through small communicating veins. Therefore, the consequences of an SVT are not the same as those associated with a DVT. With an SVT, even if the clot or a piece of the clot breaks free, it cannot fit through the small communicating veins and cannot wedge itself into one of the pulmonary arteries or its branches that results in a pulmonary embolism (PE). However, it is important to note that occasionally SVTs can become DVTs if they grow longer, and as such, require assessment and follow-up by a physician.
In approximately one of every five cases of DVT, the whole clot or a piece of the clot travels to the pulmonary arteries (blood vessels in the lungs), resulting in a pulmonary embolism (PE). The symptoms of PE can be shortness of breath/difficulty breathing, chest pain-especially pain that worsens with taking a deep breath, coughing up blood, palpitations/racing heartbeat, dizziness and sometimes fainting.
Generally, patients who receive timely and appropriate treatment of their DVT and/or PE recover rapidly and do not suffer major long term effects. However, it should be noted that untreated DVT and/or PE can lead to immediate/short-term life threatening consequences. There is a 5-30% risk of recurrent DVT/PE within 5 years after a first episode. Approximately 3% of all patients with PE suffer from a persistent blockage of blood flow through the lungs, a condition known as pulmonary hypertension which can cause symptoms of shortness of breath, leg swelling, fatigue, and chest pain. These patients require consultation with experts in the field of “Chronic Thromboembolic Pulmonary Hypertension (CTEPH)” and may eventually require lung surgery to get cured. Approximately 30-50% of patients who experience a DVT develop chronic symptoms of swelling, pain, redness, and/or discoloration in their affected leg. This condition is called Post Thrombotic Syndrome (PTS). In severe cases, PTS leads to leg ulcers which can occur one to five years after the diagnosis of DVT. The use of graduated compression stockings (GCS) can help relieve symptoms of PTS.
The goals are:
There are many different anticoagulants that can be used to treat DVT and PE, and your doctor will choose the one that is best for you. They can be in the form of pills, injections, and intravenous medication (while hospitalized). The decision on the type of anticoagulant that is prescribed to you is based on why you need a blood thinner, your other medical conditions, and other medications that you are presently taking.
The CETAC team will follow you to look into why you developed a DVT and/or PE and make recommendations about how long you will need to be treated with blood thinners in the Thrombosis Clinic. If you are treated with Warfarin (also called Coumadin®), the anticoagulation team will monitor your anticoagulation therapy in the Anticoagulation Clinic.
If you are treated with one of the newer oral agents, e.g. Rivaroxaban (Xarelto®), Apixaban (Eliquis®), you will also be followed in the DOAC Clinic.
You need to go to the Emergency Department if you are having any new symptoms of DVT or PE, or if you are having any warning signs of:
Other signs or risks of bleeding can be less obvious but also require emergency medical care such as when:
You are taking anticoagulants either because you’ve had a blood clot or you are at risk of developing one. Here are some of the most common reasons why people take anticoagulants: