Deep Vein Thrombosis (DVT): Not Just Something You Get From Long Flights

A DVT Isn’t Something You Only Get From Long Haul Flights

What Is A DVT?

A deep vein thrombosis, more commonly referred to as a DVT occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually your legs. Which in turn can result in potentially serious health effects if this thrombus blocks a blood vessel. A deep vein thrombosis usually develops in the lower leg, thigh, or pelvis, but can also occur in the arm. They may cause  pain and/or swelling but also may occur without any symptoms at all.

Potential Causes Of Deep Vein Thrombosis

A deep vein thrombosis can occur as the result of a number of medical conditions and are associated with multiple risk factors too. Medical conditions affecting how your blood clots can increase your risk of developing a DVT, but they can also happen if you simply don’t move for extended periods of time.  When still for long periods the calf muscles in your legs aren’t contracting, conversely when moving the calf muscles constantly contracting and relaxing assist the pumping, return of blood from your lower legs assisting blood circulation.  Therefore a lack of motion when still and the resulting reduction in “muscle pumping actions” can increase the risk of suffering blood clots. This is thought to be a big reason why long haul flights may contribute to the risk of developing a DVT in the lower limbs, so much so these sort of clots actually have been given a name and are sometimes referred to as “economy-class syndrome”. However the evidence is somewhat divided on long haul flights actually being a cause of deep vein thrombosis.

DVT Risk factors:

Some of the potential risk factors for suffering a deep vein thrombosis include:

  • Post surgery
  • Being confined to bed rest
  • Accident or injury
  • Being overweight
  • Coronary heart disease
  • Cigarette smoking
  • Pregnancy
  • High-dose combined oral contraceptive pill
  • Hormone therapy
  • Family history of DVT or previous thrombosis

Blood Clots Are A Serious Condition

Deep vein thrombosis is a serious condition, blood clots in your veins can end up “breaking loose” and travel through your bloodstream lodging in the pulmonary artery. Your pulmonary artery is the main blood vessel to the lungs and if the blood clot is large enough, then it can completely block the artery and leading to death if the individual doesn’t receive urgent medical attention. Clearly blocking of blood flow to the lungs via a “pulmonary embolism” is a life-threatening complication of a DVT, which is why a deep vein thrombosis is considered a medical emergency.

Anatomy Regarding A DVT

The blood flow passing through the veins in your legs generally requires assistance to return your heart, because the blood has to “flow up” rather than down. Calf muscle contraction assists this fight against gravity in returning the blood to your heart to be re-oxygenated by acting as a mechanical pump. Relaxing and compressing the veins with muscles contractions helps force the blood contained in these veins up towards the heart. This process is further aided by valves in the veins, which help by directing the flow of blood also counteracting the effects of gravity. Anything slowing the flow of blood through these deep veins can potentially cause DVT including simply long periods of sitting or lying, specifically following injury or surgery.

What To Look Out For, The Signs And Symptoms Of A DVT

  • Swelling in the affected leg (usually a single leg, it is consider rare with a lower leg blood clot for there to be swelling in both legs). Typically this swelling is noticed of the lower leg, ankle and foot.
  • Pain and tenderness on palpation in the leg, the pain often starts in the calf and can feel like soreness or cramping and may extend into the foot.
  • Redness of the skin and warmth to the touch.

Remembering that a deep vein thrombosis may sometimes occur without any noticeable symptoms and that the above symptoms are also common following any muscle injury to the calf muscle or similar muscle strain. And given that a DVT requires at the very least medical assessment and opinion it is always a case of if in doubt, get checked out.

The Warning Signs You May Have A Pulmonary Embolism

  • Feeling lightheaded, dizzy, or fainting
  • Rapid pulse
  • The onset of a sudden unexplained shortness of breath
  • Chest pain, or chest discomfort worsening when you take a deep breath, or  cough
  • Coughing up blood

As mentioned previously pulmonary embolism is a life-threatening condition and is considered a medical emergency. Therefore it cannot be stressed enough to seek medical attention immediately if you have any of the above signs or symptoms.

Assessing For A Blood Clot

To diagnose a DVT requires initially a series of questions about your history and symptoms. Following this a physical exam checking any areas for the presence of swelling, tenderness, heat, or discoloration of your skin. Following this your doctor may consider then further testing may, or may not be necessary. If further assessment to confirm or rule out a blood clot as the cause of your symptoms is required then the common investigations for assessing a DVT include having a:

  • Ultrasound scan. Through ultrasound a clot may be visible in the image, as well as this for previously confirmed blood clots an ultrasound scan can be used to monitor the blood clot over time and determine if it  is growing, or if any new clots have developed.
  • A Blood test. Almost all people who develop a severe deep vein thrombosis will present with an elevated blood level of a clot-dissolving substance called “D dimer”. The appropriate blood test referred by your doctor will detect this.
  • Venography and CT, or MRI scans are also sometimes used in the diagnosis and ongoing management of a deep vein thrombosis.

What Is The Treatment For A Blood Clot?

The aims of treatment for a blood clot is:

  • preventing the clot from getting any bigger,
  • preventing the clot from breaking loose and causing a pulmonary embolism
  • and reducing your chances of a DVT happening again.

DVT treatment typically includes:

  • Compression stockings worn from your feet to your knees, this helps prevent swelling associated with deep vein thrombosis thus the graduated compression helps reduce the chances that your blood will pool and clot. Compression stockings have been found to decrease the risk of post-surgery DVT in hospital patients.
  • Blood thinners (anticoagulants), are drugs that decrease your blood’s ability to clot. They don’t actually break up existing blood clots if you have one or some, but they can prevent clots from getting bigger, and/or reduce your risk of developing any additional clots.
  • Clotbusters (thrombolytics), are used to break up blood clots with more serious DVT’s, pulmonary embolism, or if other medications aren’t working.
  • Other treatment focuses more on the preventative by reducing risk factors such as quitting smoking, losing excess body fat, I guess in there you could also include moving more and avoiding surgery…

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific medical advice or assistance on Deep Vein Thrombosis (DVT): Not Just Something You Get From Long Flights should consult his or her general practitioner or otherwise appropriately skilled practitioner. Remembering a pulmonary embolism is considered a medical emergency and if you suspect you may have a blood clot you need to seek medical attention from a doctor.