Deep vein thrombosis (DVT) is a condition where blood clots develop inside a vein deep within the body. Though clots form in any part of the body, they usually occur in a vein in the thigh and calf muscles. It is a serious condition and poses risks if not diagnosed and treated. Fragments of the clot can break away and block blood vessels, or travel to the lungs and result in a fatal pulmonary embolism.

Managing the causes of deep vein thrombosis helps in timely prevention and treatment.

1. Symptoms
One of the most challenging aspects of this condition is that though it is quite common, it is also elusive. Occurring in about two million Americans annually, DVT causes complications in sick/hospitalized patients as well as in apparently healthy persons. Women are at a higher risk of this condition and it is a well-recognized, post-surgical complication. It can occur in cancer patients and people with certain chronic conditions.

In many cases, there are few or no symptoms. The nature of these can be vague and they can easily be confused with other conditions. Clinical diagnosis can also be unreliable, but screening can be done via blood tests like D-dimer and a definitive diagnosis is achieved through tests like venography or ultrasonography.

2. Typical signs:

• Severe pain, swelling, tenderness in the calf area of the leg with no apparent cause
• Heaviness and warmth in the area
• Cramping pain in the affected leg
• Skin discoloration behind the knee
• Increased pain when the foot is bent up towards the knee
• Deep vein thrombosis in upper extremities/arm can result in neck/shoulder pain, hand weakness and skin discoloration

3. Causes of deep vein thrombosis
The main cause of this condition is clot formation. This may be due to:

• Injury or trauma
• Surgery that damages blood vessels
• Extended bed-rest following surgery or long illness
• Decreased mobility or inactivity caused during long flights and car trips
• A side-effect of certain medications
• Family or personal history
• Pregnancy
• Obesity or being overweight
• Regular consumption of a combined contraceptive pill
• Hormone replacement therapy
• Certain genetic disorders
• Older age
• Cancer

Some rare causes of deep vein thrombosis include:

• Endurance athletics
• Inflammatory bowel disease
• Low levels of vitamin D
• Medications that contain sex hormones
• Premature birth
• Smoking

4. Management of deep vein thrombosis
Standard immediate management for the condition is hospital admission for intensive, continuous treatment with blood thinners like heparin. Heparin should be given for at least four days until the therapeutic range is maintained for two consecutive days. For this, low molecular weight heparins are used.

The condition can be further managed with the following:

• Long-term prescription of anti-coagulants
• Foot elevation in bed
• Insertion of inferior vena cava filters to reduce the rate of pulmonary embolism
• Elastic compression stockings are prescribed for the first episode of deep vein thrombosis
• In many cases, outpatient treatment is considered as an option
• Some causes of deep vein thrombosis can be managed from a prevention point of view. For instance, staying alert, active, and awake on long flights and road trips by avoiding sleeping pills and alcohol, moving around as much as possible and changing position is a helpful method
• Performing desk-exercises in office
• Taking scheduled breaks
• Staying hydrated