DEEP VEIN THROMBOSIS

DEEP VEIN THROMBOSIS
Definition:
Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling but also can occur with no symptoms.

Description:
You can get DVT if you have certain medical conditions that affect how your blood clots. A blood clot in your legs can also happen if you don't move for a long time, such as after you have surgery or an accident, when you're traveling a long distance, or when you're on bed rest.
Deep vein thrombosis can be very serious because blood clots in your veins can break loose, travel through your bloodstream and get stuck in your lungs, blocking blood flow (pulmonary embolism). However, pulmonary embolism can occur with no evidence of DVT.
When DVT and pulmonary embolism occur together, it's called venous thromboembolism (VTE).
Symptoms
DVT signs and symptoms can include:

Deep vein thrombosis can occur without noticeable symptoms.
When to see a doctor
If you develop signs or symptoms of DVT, contact your doctor.
If you develop signs or symptoms of a pulmonary embolism (PE) — a life-threatening complication of deep vein thrombosis — seek emergency medical help.
The warning signs and symptoms of a pulmonary embolism include:

Causes
Anything that prevents your blood from flowing or clotting normally can cause a blood clot.
The main causes of DVT are damage to a vein from surgery or trauma and inflammation due to infection or injury.
Risk factors
Many things can increase your risk of developing DVT. The more risk factors you have, the greater your risk of DVT. Risk factors for DVT include:

Complications
Complications of DVT can include:

Prevention
Measures to prevent deep vein thrombosis include the following:

Diagnosis
To diagnose DVT, your doctor will ask you about your symptoms. You'll also have a physical exam so that your doctor can check for areas of swelling, tenderness or changes in skin color.
The tests you have depend on whether your doctor thinks you are at a low or a high risk of DVT. Tests used to diagnose or rule out a blood clot include:

Treatment:
There are three main goals to DVT treatment.

DVT treatment options include:

Blood thinners. DVT is most commonly treated with anticoagulants, also called blood thinners. These drugs don't break up existing blood clots, but they can prevent clots from getting bigger and reduce your risk of developing more clots.
Blood thinners may be taken by mouth or given by IV or an injection under the skin. Heparin is typically given by IV. The most commonly used injectable blood thinners for DVT are enoxaparin (Lovenox) and fondaparinux (Arixtra).
After taking an injectable blood thinner for a few days, your doctor may switch you to a pill. Examples of blood thinners that you swallow include warfarin (Jantoven) and dabigatran (Pradaxa).
Certain blood thinners do not need to be given first with IV or injection. These drugs are rivaroxaban (Xarelto), apixaban (Eliquis) or edoxaban (Savaysa). They can be started immediately after diagnosis.
You might need to take blood thinner pills for three months or longer. It's important to take them exactly as prescribed to prevent serious side effects
If you take warfarin, you'll need regular blood tests to check how long it takes your blood to clot. Pregnant women shouldn't take certain blood-thinning medications.
Clot busters. Also called thrombolytics, these drugs might be prescribed if you have a more serious type of DVT or PE, or if other medications aren't working
These drugs are given either by IV or through a tube (catheter) placed directly into the clot. Clot busters can cause serious bleeding, so they're usually only used for people with severe blood clots.

Lifestyle and home remedies
Once you receive treatment for DVT, it's important to follow some lifestyle changes to manage your condition and prevent another blood clot. Lifestyle changes include:

Preparing for your appointment

DVT is considered a medical emergency, so it's important to get evaluated quickly. However, if you have time before your appointment, here's some information to help you get ready.

What you can do
Make a list of:

If possible, take a family member or friend with you to help you remember the information you're given.
For DVT, questions to ask your doctor include:

What to expect from your doctor
Your doctor is likely to ask you questions, such as:

CLAUDICATION
Definition:
Claudication is pain caused by too little blood flow to muscles during exercise. Most often this pain occurs in the legs after walking at a certain pace and for a certain amount of time — depending on the severity of the condition.

Description:
The condition is also called intermittent claudication because the pain usually isn't constant. It begins during exercise and ends with rest. As claudication worsens, however, the pain may occur during rest.
Claudication is technically a symptom of disease, most often peripheral artery disease, a narrowing of arteries in the limbs that restricts blood flow.
Treatments focus on lowering the risks of vascular disease, reducing pain, increasing mobility and preventing damage to tissues.
Symptoms
Claudication refers to muscle pain due to lack of oxygen that's triggered by activity and relieved by rest. Symptoms include the following:

The pain may become more severe over time. You may even start to have pain at rest.
Signs or symptoms of peripheral artery disease, usually in more-advanced stages, include:

When to see a doctor
Talk to your doctor if you have pain in your legs or arms when you exercise. Claudication can lead to a cycle that results in worsening cardiovascular health. Pain may make exercise intolerable, and a lack of exercise results in poorer health.
Peripheral artery disease is a sign of poor cardiovascular health and an increased risk of heart attack and stroke.
Other conditions involving the blood, nerves, and bones can contribute to leg and arm pain during exercise. It's important to have a complete exam and appropriate tests to diagnose potential causes of pain.
Causes:
Claudication is most often a symptom of peripheral artery disease. The peripheral arteries are the large vessels that deliver blood to the network of vessels in your legs and arms.
Peripheral artery disease is damage to an artery that restricts the flow of blood in an arm or leg (a limb). When you're at rest, the limited blood flow is generally still enough. When you're active, however, the muscles aren't getting enough oxygen and nutrients to work well and remain healthy.
Damage to peripheral arteries is usually caused by atherosclerosis. This is the buildup of cholesterol and other fats, blood cells, and other cellular debris into abnormal structures (plaques) on the lining of an artery.
Plaques cause a narrowing and stiffening of the artery, limiting the flow of blood. If the plaques rupture, a blood clot can form, further reducing blood flow.
Risk factors
The risk factors for peripheral artery disease and claudication include the following:

Complications
Claudication is generally considered a warning of significant atherosclerosis in the circulatory system, indicating an increased risk of heart attack or stroke. Additional complications of peripheral artery disease due to atherosclerosis include:

Prevention
The best way to prevent claudication is to maintain a healthy lifestyle and control certain medical conditions. That means:

Diagnosis
Claudication may go undiagnosed because many people consider the pain to be an unwelcome but typical part of aging. Some people simply reduce their activity level to avoid the pain.
A diagnosis of claudication and peripheral artery disease is based on a review of your symptoms, a physical exam, evaluation of the skin on your affected limbs, and tests to check blood flow.
Some common tests used to diagnose claudication may include:

Treatment
The goals of treating claudication and peripheral artery disease are to reduce pain and manage the risk factors that contribute to vascular disease.
Exercise
Exercise reduces pain, increases exercise duration, improves vascular health in the affected limbs, and contributes to weight management and an overall improvement in your quality of life.
Recommended walking programs include:

Supervised exercise is recommended for beginning the treatment, but long-term exercise at home is important for ongoing disease management.
Medications to manage risk factors
Your doctor may prescribe one or more medications to control pain and manage risk factors for vascular disease. These include drugs to manage the following:

Talk to your doctor about over-the-counter medications, supplements or other medications that you shouldn't take with your prescribed treatment.
Surgery
When peripheral artery disease is severe and other interventions do not work, surgery may be required. Options include:

Lifestyle and home remedies
A healthy lifestyle is essential for improving treatment outcomes and lowering risks associated with claudication and peripheral artery disease. Recommended lifestyle changes include the following:

Alternative medicine
Researchers have studied alternative treatments for claudication and peripheral artery including:

To date, these studies have produced negative, inconclusive or contradictory results. Talk to your doctor before starting any type of alternative to make sure it's safe for you.
Coping and support
It can be concerning to learn that the reason you're having pain is that your blood vessels are narrowing. Learning all you can about what's causing your claudication can put you in control, and you'll know exactly what steps to take to ease your pain.
Some people also find it helpful to talk with other people who are going through the same thing that they are. In a support group, you may find encouragement, advice, and maybe even an exercise partner or two. Ask your doctor if there are any support groups in your area.
Preparing for your appointment
You're likely to start by seeing your family doctor. However, you may then be referred to a doctor trained in cardiovascular diseases (cardiologist) or a vascular surgeon.
To make the best of your appointment time, be prepared to answer the following questions:

What you can do
You'll also be asked about the medications you take, including over-the-counter medications and supplements. Before your appointment, write down each drug's name, dosage, reason for taking it, and the name of the prescribing doctor. Bring the list with you to your appointment.
Other strategies to help you use your appointment time well include the following:

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