To diagnose deep vein thrombosis, 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 discoloration on your skin. Depending on how likely you are to have a blood clot, your doctor might suggest tests, including:
Ultrasound. A wandlike device (transducer) placed over the part of your body where there's a clot sends sound waves into the area. As the sound waves travel through your tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot might be visible in the image.
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.
- Blood test. Almost all people who develop severe deep vein thrombosis have an elevated blood level of a substance called D dimer.
- 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. However, less invasive methods of diagnosis, such as ultrasound, can usually confirm the diagnosis.
- CT or MRI scans. Either can provide visual images of your veins and might show if you have a clot. Sometimes these scans performed for other reasons reveal a clot.
Deep vein thrombosis (DVT) treatment is aimed at preventing the clot from getting bigger and preventing it from breaking loose and causing a pulmonary embolism. Then the goal becomes reducing your chances of deep vein thrombosis happening again.
Deep vein thrombosis treatment options include:
Blood thinners. Deep vein thrombosis is most commonly treated with anticoagulants, also called blood thinners. These drugs, which can be injected or taken as pills, decrease your blood's ability to clot. They don't break up existing blood clots, but they can prevent clots from getting bigger and reduce your risk of developing more clots.
The injectable medications can be given as a shot under the skin or by injection into your arm vein (intravenous).
Heparin is typically given intravenously. Other similar blood thinners, such as enoxaparin (Lovenox), dalteparin (Fragmin) or fondaparinux (Arixtra), are injected under the skin.
You might receive an injectable blood thinner for a few days, after which pills such as warfarin (Coumadin, Jantoven) or dabigatran (Pradaxa) are started. Once warfarin has thinned your blood, the injectable blood thinners are stopped.
Other blood thinners can be given in pill form without the need for an injectable blood thinner. These include rivaroxaban (Xarelto), apixaban (Eliquis) or edoxaban (Savaysa).
You might need to take blood thinner pills for three months or longer. It's important to take them exactly as your doctor instructs because taking too much or too little can cause serious side effects.
If you take warfarin, you'll need periodic blood tests to check how long it takes your blood to clot. Pregnant women shouldn't take certain blood-thinning medications.
Clot busters. If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren't working, your doctor might prescribe drugs that break up clots quickly, called clot busters or thrombolytics.
These drugs are either given through an IV line to break up blood clots or through a catheter placed directly into the clot. These drugs can cause serious bleeding, so they're generally reserved for severe cases of 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. To help prevent swelling associated with deep vein thrombosis, these are worn on your legs from your feet to about the level of your knees.
This pressure helps reduce the chances that your blood will pool and clot. You should wear these stockings during the day for at least two years, if possible.
Lifestyle and home remedies
Once you receive treatment for deep vein thrombosis (DVT), you need to watch your diet and watch for signs of excessive bleeding, as well as take steps to prevent another DVT. Some things you can do include:
- Check in with your doctor regularly to see if your treatment needs to be modified. If you're taking warfarin (Coumadin, Jantoven), you'll need a blood test to see how well your blood is clotting.
- Take your blood thinners as directed. If you've had DVT, you'll be on blood thinners for at least three to six months.
- Watch for excessive bleeding, which can be a side effect of taking 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 less likely blood clots will develop.
- Wear compression stockings to help prevent blood clots in the legs if your doctor recommends them.
Preparing for your appointment
Deep vein thrombosis (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 if you have a family history of blood-clotting disorders, and whether you have been hospitalized, or have had illnesses, surgery or trauma in the past three months, or have been traveling
- All medications, vitamins or other supplements you take, including doses
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you're given.
For deep vein thrombosis, 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?