Deep vein thrombosis is the formation of a blood clot within the blood vessel. The condition is deadly because as medics explain, it prevents blood from flowing normally through the circulatory system. Dr Immaculate Kambutse, a physician in internal medicine at Oshen-King Faisal Hospital, explains that deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, typically in the legs, though it can also develop in other areas of the body. Deep vein thrombosis can present leg pain and/or swelling, but can also occur with no symptoms. Sometimes, blood clots in a patient’s deep veins can break loose; causing a serious complication called pulmonary embolism, whereby a clot travels through the bloodstream and lodges in the pulmonary artery, blocking blood flow to the lungs, she explains. CAUSES OF DVT Dr Kambutse says that anything that prevents the blood from circulating or clotting normally in the body can lead to DVT. These factors are usually grouped into a triad: stasis, endothelial injury and hypercoagulable states. Stasis entails limited movement, where one remains still for a long period. For example, prolonged bed rest, such as during a long hospital stay or paralysis, long hours of travel, among other factors, the physician says. With immobility, the calf muscles (in the leg) don’t contract to help blood flow, which can increase the risk of blood clots. Endothelial injury means injury to a blood vessel wall and this can happen, for example, following surgery. Hypercoagulable encompasses conditions in which blood tends to clot more than normal. For example, during pregnancy, use of some medications, cancer, as well as inherited conditions that affect blood clotting mechanisms. “The above have been well identified as risk factors for developing deep vein thrombosis,” she says. SIGNS AND SYMPTOMS Dr Kambutse notes that signs and symptoms depend on which deep veins are affected, adding that some patients may, however, not experience any symptoms initially. “For deep vein thrombosis in the leg, pain is a common sign noticed by patients that brings them to the hospital. Other symptoms include swelling of the leg (usually one sided), an area of skin that feels warmer than the skin on the surrounding areas, a reddish skin discolouration over the affected area,” the medic explains. Pulmonary embolism, a complication of deep vein thrombosis, can present difficulty in breathing, chest pain with taking in deep breaths, and unexplained cough that is sometimes associated with spitting up blood, she adds. MANAGEMENT Dr Kambutse says that identifying and managing this condition is lifesaving. Patients are advised to seek medical advice in case they notice symptoms. “The goal of treatment is to prevent the clot from getting bigger and also stopping it from breaking loose and causing pulmonary embolism, avoid complications of DVT and also prevent possible medication-related complications,” she says. Anticoagulants, commonly referred to as “blood thinners” are medications used for the treatment of the ailment. “The most commonly used treatment at Oshen-King Faisal Hospital is low molecular weight heparin which we overlap with an oral anticoagulant like warfarin. We do this for a couple of days until we are sure we have achieved our targets for treatment and then the patient can be discharged on oral treatment (a tablet which they can take for an extended period of time).” Dr Kambutse also mentions prevention strategies that would be helpful in fighting deep vein thrombosis. Some of these include losing weight — that is if one is overweight, regular exercises, quitting smoking and avoiding staying still for long periods (calf exercises, frequent walking when one is on a plane or long car trip). editorial@newtimes.co.rw
