Deep Vein Thrombosis
(DVT, Blood Clot in the Legs)
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
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How Pie Prevents Blood Clots
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
 This weekend, as I drove
the 5 hours to the north Wisconsin woods, I reminded myself of advice I give to
my patients: remember to get out of the car and move around. It's also why,
buried deep in the recesses of the in flight magazine, somewhere between the
movie grid and the duty free opportunities, hides a warning that staying still
in an airplane seat for a prolonged time can cause
blood clots. And while the
magazine recommends moving around the cabin and stretching, the flight
attendants tend to want to keep you in your seat.
Blood does wonderful things like carrying oxygen, cleaning waste products,
and delivering cells and chemicals to fight infection. But mess up its
environment and blood can cause all sorts of problems. Blood cells get pushed by
the heart to the far recesses of the body, but returns from the fingers, toes,
arms and legs in veins that are milked by the routine contractions of the
muscles that surround them. As you walk, blood gets pushed back to the heart; as
you type, the muscles of your fingers and hands do the work to get the blood
back.
Without that muscle movement, blood stagnates and has a tendency to clot...
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Introduction to deep vein thrombosis (DVT)
Arteries have thin muscles within their walls to be able to withstand
the pressure of the heart pumping blood to the far reaches of the body.
Veins don't have a significant muscle lining, and there is nothing pumping blood
back to the heart except physiology. Blood returns to the heart because
the body's large muscles squeeze the veins as they contract in their
normal activity of moving the body. The normal activities of moving the
body returns the blood back to the heart.
There are two types of veins in the leg; superficial veins and deep veins. Superficial veins lie just below the skin and are easily seen on the surface.
Deep veins, as their name implies, are located deep within the muscles of
the leg. Blood flows from the superficial veins into the deep venous system through
small perforator veins. Superficial and perforator veins have one-way valves
within them that allow blood to flow only in the direction of the heart when the
veins are squeezed.
A blood clot (thrombus) in the deep venous system of the leg is not dangerous in
itself. The situation becomes life-threatening when a piece of the blood clot breaks off
(embolus, pleural=emboli), travels downstream through the heart into the
pulmonary circulation system, and becomes lodged in the lung. Diagnosis and
treatment of a deep venous thrombosis (DVT) is meant to prevent pulmonary embolism.
Clots in the superficial veins do not pose a danger of causing pulmonary
emboli because the perforator vein valves act as a sieve to prevent clots from
entering the deep venous system. They are usually not at risk of causing pulmonary
embolism.
Picture of a blood clot is formed
What are the causes of deep vein thrombosis?
Blood is meant to flow; if it becomes stagnant there is a potential for it to
clot. The blood in veins is constantly forming microscopic clots that are
routinely broken down by the body. If the balance of clot formation and
resolution is altered, significant clotting can occur. A thrombus can form if
one, or a combination of the following situations is present.
Immobility
- Prolonged travel and sitting, such as long airplane flights ("economy
class syndrome"), car, or train travel
- Hospitalization
- Surgery
- Trauma to the lower leg with or without surgery or casting
- Pregnancy, including 6-8 weeks post partum
- Obesity
Hypercoagulability (coagulation of blood faster than usual)
Trauma to the vein
Next: What are the symptoms of deep vein thrombosis? »
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