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Deep Vein Thrombosis (DVT) / Thrombophlebitis

Illustration of the circulation system of the legs
Click Image to Enlarge

Deep vein thrombosis (DVT) is a blood clot or thrombus in a deep vein. DVTs are most common in the leg, but one may develop in a large vein deep inside the arm, or other part of the body. Part of the clot, called an embolus, can break off and travel to the lungs. This is a pulmonary embolus (PE). This can cut off the flow of blood. PE is an emergency and may cause death. 

Two other complications of deep vein thrombosis are chronic venous insufficency and post-thrombotic syndrome.

  • Chronic venous insufficiency may occur following deep vein thrombosis of a leg vein. It means that a vein no longer works well. It is a long-term condition where blood pools in the vein instead of flowing back to the heart. Pain and swelling in the leg are common symptoms. 

  • Post-thrombotic syndrome may also occur following deep vein thromobosis of a leg vein. It is a long-term problem with pain, swelling, and redness. Ulcers and sores can also occur. All of these symptoms may make it difficult to walk and take part in daily activities.

Health care providers use the term venous thromboembolism (VTE) to describe both DVT and PE.  They use the term VTE because the two conditions are very closely related. And, because their prevention and treatment are also closely related. 

Illustration of deep vein thrombosis of the leg
Click Image to Enlarge

What are the risk factors for deep vein thrombosis?

Risk factors include:

  • Obesity

  • Blood clotting disorder

  • Age over than 60 years

  • Surgery

  • A long period of not moving, for example, when in the hospital or on a long trip

  • Birth control pills or hormone replacement therapy

  • Certain diseases and conditions, such as:

    • Previous blood clot

    • Varicose veins

    • Heart problems, such as heart failure, or heart attack

    • Inflammatory bowel disease

    • Lupus, a disease of the immune system

    • Cancer and some cancer treatments

  • Paralysis

  • Pregnancy

  • Having  a central venous catheter, for example, in a large vein in the chest

What are the symptoms of deep vein thrombosis?

Deep vein thrombosis may occur without symptoms. When symptoms do occur, they may include:

  • Pain, redness, swelling, or warmth in the leg, arm, or other area

  • Dull ache or tight feeling when walking or standing (for a deep vein thrombosis in the leg)

  • Rapid heart beat

  • Slight fever

  • More visible surface veins

The symptoms of deep vein thrombosis may look like other medical conditions or problems. Always see your doctor for a diagnosis.

How is deep vein thrombosis diagnosed?

Along with a medical history and physical exam, your doctor may do other tests including:

  • Duplex ultrasound. This procedure involves placing ultrasound gel on the affected area and then moving a handheld device across it. A picture of the blood flow is displayed on a monitor. Duplex ultrasound is the most common test for DVT.

  • Lab work. Blood work may be done to look for evidence of blood clotting and other problems.

What is the treatment for deep vein thrombosis?

Specific treatment will be determined by your doctor based on: 

  • How old you are

  • Your overall health and medical history

  • How sick you are

  • How well you can handle specific medications, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

The goal of treatment is to prevent the clot from getting larger, to prevent pulmonary embolism, and to decrease the chance of another blood clot forming.

Treatment may include:

  • Blood thinners (anticoagulant medications). These medications decrease the ability of the blood to clot. Examples of anticoagulants include warfarin (Coumadin) and heparin. Newer anticoagulants may also be used, including rivaroxaban, apixaban, dabigatran and enoxaparin. Warfarin (Coumadin) pills or heparin shots (injections). The most common side effect of blood-thinning medication is bleeding. Report bruising or bleeding to your doctor right away.

  • Clot busters (fibrinolytics or thrombolytics). These medicines are used to break up clots.

  • Vena cava filter. In some cases a filter is placed in the vena cava (the large vein which returns blood from the body to the heart). This filter prevents clots from reaching the heart and lungs.

How can deep vein thrombosis be prevented?

Preventing deep vein thrombosis can include:

  • Anticoagulant medications are given to certain surgical patients to prevent deep vein thrombosis.

  • Wiggling the toes and moving the ankles helps to prevent deep vein thrombosis caused by long periods of sitting or lying down.

  • When you travel and must sit for long periods of time you can reduce your risk of DVT by doing the following: 

    • Walk up and down the aisles (if traveling by plane or bus)

    • Stop about every hour and walk a little (if traveling by car)

    • While sitting, move your legs, ankles, and toes

    • Wear loose clothing

    • Avoid alcohol

    • Drink plenty of fluids

Prevention may also include: 

  • Walking. Getting up and moving as soon as possible after surgery or illness

  • Pneumatic compression device. A machine that applies gentle pressure to the legs

  • Elastic or compression stockings

Consult your doctor for diagnosis and treatment.

Online Medical Reviewer: Holloway, Beth, RN, M.Ed.
Online Medical Reviewer: Petersen, Sheralee, MPAS, PA-C
Date Last Reviewed: 3/31/2015
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