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:
- D-dimer blood test. D dimer is a type of protein produced by blood clots. Almost all people with severe DVT have increased blood levels of D dimer. A normal result on a D-dimer test often can help rule out PE.
- Duplex ultrasound. This noninvasive test uses sound waves to create pictures of how blood flows through your veins. It's the standard test for diagnosing DVT. For the test, a technician gently moves a small hand-held device (transducer) on your skin over the body area being studied. Sometimes a series of ultrasounds are done over several days to determine whether a blood clot is growing or to check for a new one.
- Venography. A dye is injected into a large vein in your foot or ankle. An X-ray creates an image of the veins in your legs and feet, to look for clots. The test is invasive, so it's rarely performed. Other tests, such as ultrasound, often are done first.
- Magnetic resonance imaging (MRI) scan. This test may be done to diagnose DVT in veins of the abdomen.
Compression stockings, also called support stockings, compress the legs, improving blood flow. A device called a stocking butler might help with putting on the stockings.
There are three main goals to DVT treatment.
- Prevent the clot from getting bigger.
- Prevent the clot from breaking loose and traveling to the lungs.
- Reduce your chances of another DVT.
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.
- Filters. If you can't take medicines to thin your blood, you might have a filter inserted into a large vein — the vena cava — in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs.
- Compression stockings. These special knee socks reduce the chances that your blood will pool and clot. To help prevent swelling associated with deep vein thrombosis, wear them on your legs from your feet to about the level of your knees. You should wear these stockings during the day for at least two years, if possible.
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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:
- Ask your doctor about your diet. Foods high in vitamin K, such as spinach, kale, other leafy greens and Brussels sprouts, can interfere with warfarin.
- Take your medications as directed. Your doctor will tell you how long you will need treatment. If you're taking certain blood thinners, you'll need a blood test to see how well your blood is clotting.
- Watch for excessive bleeding. This can be a side effect of blood thinners. Talk to your doctor about activities that could cause you to bruise or get cut, as even a minor injury could become serious if you're taking blood thinners.
- Move. If you've been on bed rest because of surgery or other factors, the sooner you get moving, the lower the chance that blood clots will develop.
- Wear compression stockings. Wear these to help prevent blood clots in the legs if your doctor recommends them.
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:
- Your symptoms, including any that seem unrelated to deep vein thrombosis, and when they began
- Key personal information, including notes about travel, hospital stays, any illness, surgery or trauma in the past three months, and any personal or family history of blood-clotting disorders
- All medications, vitamins or other supplements you take, including doses
- Questions to ask your doctor
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's the most likely cause of my symptoms?
- What tests do I need?
- What's the best treatment?
- What are the alternatives to the primary approach that you're suggesting?
- Will I need to restrict my physical activity or travel?
- I have other health conditions. How can I best manage these conditions together?
- Are there brochures or other printed material I can have? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- Have you been inactive lately, such as sitting or lying down for long periods?
- Do your symptoms bother you all the time, or do they come and go?
- How severe are your symptoms?
- What, if anything, makes your symptoms improve?
- Does anything worsen your symptoms?
Dec. 22, 2020
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