Blood Clots in the Legs Diagnosis and Treatment

Blood clots in the leg or Deep Vein Thrombosis (DVT) is a serious condition that involves blood clot formation in a vein. The blood clot forms in the deep veins of the legs, it forms due to a vein damage or if the flow of blood in the vein is slow or has stopped for some reason. The symptoms include pain and swelling in the legs, leg warmth and redness but it has been observed that some times no symptoms appear. Pulmonary Embolism results if the clot detaches and starts traveling in the blood stream, which may cause damage to the lungs. Pulmonary Embolism causes chest pain and the patient complaints of the shortness of breath. If there is severe lung damage, the chances of death are higher. Patient can be treated before a great loss. There are many effective procedures to prevent blood clots and these effective measures can be taken before DVT happens.

If the medical practitioner suspects a DVT then a he or she must order test to determine the presence of blood clot in the leg. Most common tests that are advised are:

d-Dimer test is one type of blood test that is used to observe the blood clot formation. In this test, if the results show a negative or normal d-Dimer , then it rules out that there is a possibility of blood clot formation but if the results show a positive or elevated sense of d-Dimer then additional testing will be required to verify whether a blood clot really exists but it does not mean that there is a blood clot.

Ultra sound scan of legs for identifying large clots above the knee in patients who have symptoms of DVT.

Blood samples for checking the clotting problems related to inherited conditions that may risk in DVT.

Venogram is the most accurate method to rule out a blood clot in the veins. A dye is injected in the veins in the foot and an x-ray of the veins is taken to see if a clot is present. The dye causes some discomfort to the patient and in some cases also stimulates the blood to clot. Venogram is only advised when the there is some kind of uncertainty in the ultrasound.

Once a DVT is diagnosed, the patient will require a prompt treatment. The treatment will prevent the clot from getting bigger then its actual size, it will stop the clot from traveling to the lungs and the preventive treatment will seize the new clots from forming and will also stop the post thrombotic syndrome.

A DVT patient is treated with anticoagulant medicines. Heparin or low molecular heparin is injected in arm vein or is injected under the skin for many days. These anticoagulants stop the blood clotting system in the body.

After a few days, warafin tablets are given to the patient while heparin is continued with it for five days. The patients’ INR is monitored and Heparin is not stopped until INR is stable. INR test measures warafin effectiveness. Regular blood test are done such as PT-INR to check if lesser or higher amounts of drugs been taken. Warafin shall be taken by the patient depending upon the cause of the blood to clot. For example, if the patient had a first blood clot that occurred due to trauma or a surgery, then the 3 months of anticoagulation are prescribed. If the cause was a chronic condition then anticoagulation will be continued for 6 to 12 months. If the patient has two clots or he has a biochemical risk that would increase the clot formation then warafin will be continued life long. These anticoagulation drugs do not help in dissolving the clots, these drugs help to stop existing ones from growing and new blood clots from forming. The body naturally dissolves the clot over a certain time period. Other then these, thrombolytics are also given to patients to dissolve the DVT but are used in severe cases.

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Posted on Apr 29, 2010