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Deep vein thrombosis (DVT)

Key points

  • Deep vein thrombosis (DVT) is when a blood clot forms in a deep vein in your leg.
  • Every year, about one in 1,000 people develop DVT in the UK.
  • Symptoms of DVT include pain, swelling and redness, usually in your lower leg.
  • The main treatment for DVT is anticlotting (anticoagulant) medicines, which reduce your blood’s ability to clot.
  • You can reduce your risk of DVT by stopping smoking and losing excess weight.

Video: how DVT forms

This section contains answers to frequently asked questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

If I have had a deep vein thrombosis, am I at a greater risk of getting another one?

Answer

About three in 10 people who have had a DVT or pulmonary embolism will have another one within 10 years of the first. This is most likely during the first two years afterwards, and your risk of developing DVT decreases over time. You’re also more at risk if your first DVT didn’t happen after surgery or an accident. You can reduce your risk of developing DVT again by continuing to take any medicines that your doctor prescribes for you and making any lifestyle changes that he or she advises.

Explanation

Having a DVT increases your chance of having one again. You're more likely to develop a DVT again if the first one occurred without an obvious cause or you got it because of an underlying medical condition that hasn't gone away since then. You're less likely to have one again if you developed a DVT because of a one-off event, such as an operation.

If you develop DVT, your doctor will probably first treat you with injections of an anticlotting medicine called low molecular weight heparin followed by warfarin that you take by mouth. How long you need to take this medicine for will depend on what caused your DVT and how likely you are to develop it again. You may only need to take it for a few months, but it’s possible that you will need to continue taking this medicine for life. You may be advised to wear compression stockings for at least two years.

Because you have already had DVT, you will be more likely to develop it after long-distance travel than someone who has never had DVT. Therefore, it’s important to get medical advice before making any travel plans that involve long journeys.
 

I'm having an operation. How can I reduce my risk of deep vein thrombosis?

Answer

There are a number of things that can help to prevent DVT and your surgeon or nurse will be able to give you information about these. You can also reduce your risk of developing DVT by following your surgeon or nurse’s advice about treatment after surgery. This may include getting up and about as soon as possible after your operation and taking the medicines that have been prescribed for you.

Explanation

Your risk of developing DVT after an operation depends on a number of things, including the type of surgery you’re having and whether you have any other risk factors. In addition, being inactive increases your risk of DVT. After an operation, it’s possible that you will need to spend a lot of time in bed and won’t be able to move around a great deal.

Your surgeon or nurse will assess you when you go into hospital for your operation and will develop a plan to help prevent DVT. This will include information about your risk of developing DVT, what you can do to reduce this and what you need to do once you go home. This is likely to include stopping smoking, wearing compression stockings, taking anticlotting medicines and doing foot and leg exercises when you're in bed or inactive.

Other ways to reduce your risk may include the following.

  • If you're taking the contraceptive pill, your surgeon may ask you to stop taking it and use other methods of contraception for the month before your operation.
  • You may be asked to wear compression stockings, before, during and after your operation until you're back to your usual levels of mobility and activity. These help to keep the blood flowing well through your legs by squeezing your muscles and prevent clots from forming. Sometimes these can be attached to a device that fills the stockings with air and then deflates them, helping to squeeze your leg muscles.
  • Your surgeon or nurse will encourage you to get up and move around as soon as you can after your operation. You will also be shown some foot and leg exercises to do while you're in bed or not very active. These increase the blood flow in your legs, which can help to prevent clots.
  • Make sure you drink enough fluid as soon as you're able to after your operation. Staying properly hydrated can help to prevent blood clots.
  • You may need to have injections of a medicine called low molecular weight heparin to help thin your blood. You will need to have these injections until you're up and about and back to your usual level of mobility, or maybe for longer, for example after a hip replacement. There are also new medicines that are available in tablet form, such as rivaroxaban, that you may be given as an alternative to injections. However, these aren't suitable for everyone.

If you don't get this information, it’s important that you ask for it.

Are there any risks associated with taking warfarin to treat deep vein thrombosis?

Answer

Warfarin is an anticlotting medicine that you may need to take for several months after DVT. Like all medicines, warfarin can have side-effects but you can reduce your risk of these by taking it every day as your doctor prescribes. You will also need to have regular blood tests.

Explanation

Warfarin is the anticlotting medicine that you’re most likely to be prescribed after DVT. You take it as one or more tablets once a day and it's important that you take it at the same time every day. Like all medicines, warfarin can have side-effects, but you can reduce your risk of these by following the advice below.

  • Make sure you go for your blood tests. You will have regular blood tests when taking warfarin to monitor how well the medicine is working and to make sure you're taking the right amount. Too much can cause bleeding and too little can increase your risk of another clot forming. You will need blood tests every day or every other day when you first start taking the medicine. Depending on how well it works for you, you will then need to have these less often and eventually only every 12 weeks.
  • Carry an alert card or wear a medical bracelet that indicates that you’re taking warfarin. It's important that any health professional who treats you knows that you're taking an anticlotting medicine because it can affect your treatment and interfere with other medicines. This includes over-the-counter medicines that don't need a prescription and any complementary or herbal remedies. Tell any doctor, nurse or pharmacist who treats you that you’re taking anticlotting medicines. If you have an accident and need emergency treatment, carrying a card or wearing a bracelet will alert medical staff to this.
  • Don't drink cranberry juice if you're taking warfarin because it can affect the way that warfarin works in your body. Eating large amounts of green vegetables, for example, broccoli, can have an effect on warfarin because they contain a lot of vitamin K, which affects how well it works. Alcohol and grapefruit juice have also been reported to interact with warfarin. Talk to your doctor for more information and before making any changes to your diet.
  • Look out for signs of abnormal bleeding such as excessive bruising, bleeding gums, blood in your urine, black faeces or nose bleeds. These symptoms may mean that your dose of warfarin is too high and it’s important that you seek urgent medical advice straight away.
  • Warfarin can damage an unborn baby so if you are or think you may be pregnant, it’s important that you get urgent advice from your GP about alternative anticlotting medicines.

 

Produced by Polly Kerr, Bupa Health Information Team, April 2013.

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