Anisha Shah, MD, is a board-certified internist, interventional cardiologist, and a fellow of the American College of Cardiology.
Deep vein thrombosis (DVT) is a blood clot that partially or completely blocks a large vein (usually in the lower leg or thigh, like the popliteal vein) though it can occur in other parts of the body.
DVT prevents deoxygenated blood from returning to the heart. As a result, circulation is blocked in the leg, which leads to pain and swelling.
If that blood clot breaks off, it becomes an embolus and can travel through the heart and lungs, blocking passage for blood flow there. A blood clot that travels to your lungs is called pulmonary embolism (PE). PE can deprive the tissues of blood and damage tissues. DVT is very serious and can be fatal.
According to the National Heart, Lung and Blood Institute, blood clots in the thighs are more likely to break off and cause PE than blood clots in the lower leg.
The Centers for Disease Control and Prevention estimates that as many as 900,000 Americans suffer from deep vein thrombosis or PE each year and that 60,000 to 100,000 people die as a result.
It's important to note that DVT is different from a blood clot, which forms in the veins just beneath the skin, known as superficial thrombophlebitis. Superficial thrombophlebitis doesn't usually travel to the lungs and can be treated with anti-inflammatory medications, bed rest, and warm compresses. DVTs are also different from blood clots that occur in the arteries, which can lead to a heart attack or stroke.
Common symptoms of DVT are pain and tenderness in the affected area, and redness or discoloration of the skin. If the DVT breaks off and becomes a PE, you may experience sudden chest pain or chest discomfort that worsens when you take deep breaths, rapid heartbeat, and/or difficulty breathing. Vomiting, coughing up blood, and fainting are also signs of a PE.
DVT and PE are serious, so if you have any of these signs or symptoms, seek help immediately.
One of the biggest causes of DVT is being immobile and sitting for extended periods of time. Whether you're recovering from surgery or sitting on a long flight, being inactive slows the blood flow and can prevent the platelets and plasma in your blood from mixing and circulating properly.
Having a major injury or surgery in the leg can also cause DVT, as can smoking.
Adults over age 60 are at the greatest risk for DVT, but women who are pregnant, taking birth control pills, or undergoing hormone replacement therapy are also at risk of clotting. This is due to the increased levels of estrogen, which can cause blood to clot easily.
If you have a DVT, it's important to get diagnosed right away before it becomes a pulmonary embolism. Once a PE blocks an artery in your lung, all blood flow is reduced or stopped completely, which can cause sudden death.
Your healthcare provider will most likely perform a compression ultrasound, but other tests, like a venogram, CT scan, or D-dimer test, can also be used to diagnose DVT. Through a compression ultrasound, your practitioner is able to see the blood clot and the obstruction of blood flow in the vein.
If your healthcare provider confirms a DVT diagnosis, the first line of treatment is usually anticoagulants (blood thinners). Anticoagulants do not break up existing clots, but work to prevent further blood clotting in the veins and reduce your chances of developing a PE. There are injectable and pill forms of anticoagulants.
If you do develop a PE and have a large clot, you may be prescribed thrombolytic therapy (clot-busting medication). These medications are given through IV or a catheter injected directly into the clot. Clot busting medications are typically reserved for emergency cases due to the risk for severe bleeding.
Treatment guidelines have been updated to conditionally recommend that certain people with DVT or PE with a low risk of complications can be treated at home instead of the hospital.
Get our printable guide for your next doctor's appointment to help you ask the right questions.
Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Once short-term treatment is done, your healthcare provider may put you on another anticoagulant. Anticoagulation therapy usually continues for three months, but in some cases, it can be indefinite, especially if you've had a PE. Your practitioner will evaluate your case against the risks and benefits as part of their clinical decision-making.
In 2020, the American Society of Hematology (ASH) released updated treatment guidelines for DVT and PE. Updates to these evidence-based treatment recommendations to be aware of include:
It's important for people at risk of DVT, or those who have had one, to maintain a healthy lifestyle. Quitting smoking, achieving a healthy weight, and following a regular exercise routine are all helpful prevention strategies.
You should avoid sitting for long periods of time and stretch and move throughout the day. Compression socks are especially helpful on long flights because they aid in circulation and help the leg veins return deoxygenated blood to the heart.
If you're taking birth control or hormone replacement therapy, you can talk to your healthcare provider about changing your treatment plan to prevent future clots. People who have hypertension, heart disease, or heart failure are also at a high risk of DVT, so be sure to talk with your healthcare provider about creating a treatment plan that lowers your risk and prevents clots.
Deep vein thrombosis is a serious condition that should be treated immediately. It usually takes three to six months for the clot to completely resolve, but through medical treatment, you can prevent the clot from increasing in size and breaking away.
If you experience symptoms of pulmonary embolism, get help right away. While the symptoms of DVT can be alarming, knowing them can help save your life or someone you know.
The National Heart, Lung and Blood Institute. Deep vein thrombosis.
Lee JS, Moon T, Kim TH, et al. Deep vein thrombosis in patients with pulmonary embolism: Prevalance, clinical significance and outcome. Vasc Specialist Int. 2016;32(4):166–174. doi:10.5758/vsi.2016.32.4.166
Centers for Disease Control and Prevention. Data and statistics on venous thromboembolism.
Cosmi B. Management of superficial vein thrombosis. J Thromb Haemost. 2015;13(7):1175-83. doi: 10.1111/jth.12986
Kesieme E, Kesieme C, Jebbin N, Irekpita E, Dongo A. Deep vein thrombosis: a clinical review. J Blood Med. 2011;2:59–69. doi:10.2147/JBM.S19009
Suadicani P, Hannerz H, Bach E, Gyntelberg F. Jobs encompassing prolonged sitting in cramped positions and risk of venous thromboembolism: cohort study. JRSM Short Rep. 2012;3(2):8. doi:10.1258/shorts.2011.011121
Kapoor CS, Mehta AK, Patel K, Golwala PP. Prevalence of deep vein thrombosis in patients with lower limb trauma. J Clin Orthop Trauma. 2016;7(Suppl 2):220–224. doi:10.1016/j.jcot.2016.07.003
Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ. 2019;364:k4810. doi: 10.1136/bmj.k4810.
Stone J, Hangge P, Albadawi H, et al. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther. 2017;7(Suppl 3):S276–S284. doi:10.21037/cdt.2017.09.01
Baker M, dela Cruz J. Deep venous thrombosis ultrasound evaluation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020 Oct 13;4(19):4693-4738. doi: 10.1182/bloodadvances.2020001830.
Clarke MJ, Broderick C, Hopewell S, Juszczak E, Eisinga A. Compression stockings for preventing deep vein thrombosis in airline passengers. Cochrane Database Syst Rev. 2016;9:CD004002. doi: 10.1002/14651858.CD004002.pub3
Piparva KG, Buch JG. Deep vein thrombosis in a woman taking oral combined contraceptive pills. J Pharmacol Pharmacother. 2011;2(3):185–186. doi:10.4103/0976-500X.83284
Centers for Disease Control and Prevention. Venous thomboembolism (blood clot) data & statistics.
Centers for Disease Control and Prevention. Basics of venous thromboembolism.
The American Society of Hematology. Blood clots.
The National Heart, Lung and Blood Institute. Deep vein thrombosis.
By Sharon Basaraba Sharon Basaraba is an award-winning reporter and senior scientific communications advisor for Alberta Health Services in Alberta, Canada.
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.