Deep vein thrombosis: Understanding its risk factors, preventive measures, and related aspects

Deepvein thrombosis: Causes, prevention strategies, and further details

Deep Vein Thrombosis (DVT) is a serious condition that occurs when a blood clot forms in a vein deep within the body, usually in the leg. This article aims to shed light on the common risk factors, preventive measures, and symptoms of DVT.

DVT risk is multifactorial and not limited to the classic Virchow triad (endothelial injury, stasis, hypercoagulability). Lifestyle, age, medication use, and systemic health conditions all contribute significantly to the risk.

One of the most common risk factors is prolonged inactivity or immobilization, such as during long travel by plane, car, or train; hospitalization; or bed rest. This leads to venous stasis, a condition where blood flow is reduced, increasing the risk of DVT.

Obesity is another significant risk factor. Excess body weight increases pressure on leg veins and promotes blood stickiness through substances produced by fat cells. Smoking, which damages blood vessels and increases clot formation risk, also contributes to the risk, especially when combined with other factors.

Age is a factor as well, with the risk rising notably after 60 years because blood tends to become stickier. A family history or personal history of blood clots indicates a predisposition to DVT.

Certain medications, including oral contraceptives, hormone replacement therapy, and frequent NSAID use (especially noted in athletes), can increase the risk of DVT. Frequent air travel, especially involving prolonged sitting during long flights, can also induce venous stasis and increase the risk.

Repeated trauma or surgeries, particularly around veins, can damage endothelium and induce hypercoagulability, increasing the risk of DVT. Dehydration, often in athletes or during intense physical activity, can thicken the blood and increase thrombosis risk.

Specific chronic medical conditions such as heart failure, cancer, inflammatory bowel disease, nephrotic syndrome, and vasculitis that affect blood coagulability or circulation can also increase the risk of DVT.

To reduce the likelihood of developing DVT, a person may take several steps. These include avoiding long periods of immobility, increasing movement, walking around every 30 minutes when sitting for long periods, exercising the legs while sitting, maintaining a moderate weight, wearing loose-fitting clothing, taking anticoagulants at a doctor's recommendation, maintaining an active lifestyle, and wearing graduated compression stockings.

A doctor can assess a person's risk for DVT and advise on steps they can take to reduce the likelihood of developing the condition. Wearing graduated compression stockings may also help reduce the risk of DVT, and a doctor can advise on what class of compression stockings a person should wear and for how long they should wear them.

It is crucial to note that a person can inherit some risk factors for DVT, including protein C deficiency, factor V Leiden mutation, prothrombin gene mutation, dysfibrinogenemia, hyperhomocysteinemia, antithrombin deficiency, factor XII deficiency, having a non-O blood group, and a family history of DVT or pulmonary embolism.

Other factors that can contribute to DVT risk include being over the age of 40 years, obesity, family history of DVT, smoking, and deficiency in folate or vitamin B12.

Certain medical conditions and infections can increase the risk of DVT, including lung disease, heart disease, inflammatory bowel disease, cancer or related treatments, asthma, obstructive sleep apnea, kidney disease, polycystic ovary syndrome, diabetes, rheumatological conditions, sepsis, and COVID-19.

Hormonal changes can influence the risk of DVT, with an increase in estrogen increasing a person's risk. Causes of estrogen increase include the use of birth control pills, pregnancy, and hormone replacement therapy.

Injury to veins can increase the risk of DVT, with causes including surgery, physical trauma, previous DVT, peripherally inserted venous catheters, and intravenous drug use.

If a person develops symptoms that could indicate DVT, such as tenderness or pain, swelling, red or discolored skin, thickening or firmness of a vein, distended veins, they should contact a doctor immediately. Treating DVT can help reduce the risk of pulmonary embolism, which can be fatal in some cases. The doctor can advise on suitable treatments for DVT, including anticoagulants, thrombolytics, and surgery in severe cases.