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Deep Vein Thrombosis - Medical Negligence

A deep vein thrombosis (DVT) is a disease in which a clot forms within one or more of the deep veins in the body. Deep vein thromboses are more common in the legs but can form in the deep veins of the arms and chest as well. Leg pain is the most common symptom but many people have few or no symptoms of the disease. You can get a deep vein thrombosis if you're on bed rest, if you sit for a long time in a car or plan or if you have a condition of increased clotting. It can be a serious condition with fatal complications. Most DVTs dissolve on their own, however, and half of all DVTs have no symptoms at all.

If symptoms do exist, it often causes swelling in the foot and ankle of the affected leg. There can be calf pain or ankle and foot pain. There can be warmth and redness over the back of the lower leg and you can get arm and neck pain if the DVT is occurring in the arm, axilla or neck. You should see a doctor if you get signs or symptoms of this condition as the complications can be serious.

The most serious complication of a deep vein thrombosis is unexplained shortness of breath, when the DVT breaks off and causes a pulmonary embolus. If you get chest pain that gets worse when you take a deep breath or cough, this could mean you have a pulmonary embolism. Light headed feelings, dizziness or fainting should be looked at as should coughing up blood or having an anxious feeling of impending doom.

Risk factors include:

• Having a blood clotting disorder
• Sitting or lying for long periods of time
• Hospital or home bed rest
• Having an injury that affects the veins in your legs or arms
• Having cancer
• Pregnancy
• Having poor blood circulation as in congestive heart failure
• Using hormone replacement therapy or birth control pills
• Having a tube within the vein
• Having a previous DVT or pulmonary embolus
• Having a family history of DVT or pulmonary embolism
• Being obese or overweight
• Having a history of smoking

The pulmonary embolism or PE is the worst complication of a deep vein thrombosis. It happens when the DVT or portions thereof break off and travel to the lungs. The clot interferes with blood flow to the lungs and, depending on the size of the clot, the condition can be immediately fatal. If not immediately fatal, you can get shortness of breath, lightheadness or dizziness, coughing up blood, fainting and a sense of anxiety or nervousness.

A condition called post-thrombotic syndrome can occur after getting a DVT. The symptoms of post-thrombotic syndrome include leg pain, swelling of the legs, and a brow discoloration to the skin.

The diagnosis of DVT is made by using an ultrasound that can compress the artery and show whether or not flow is going through the artery. An ultrasound is often repeated over several days to check on the growth of the DVT. CT scans can also show clots within veins as can MRI exams. Clots may be found incidentally when the scans are done for other reasons. Those who have an active DVT show evidence in the blood of an elevated D-dimer. An increased D-dimer test is suspicious for DVT. In difficult cases, a venogram can be done in which a dye is inserted into the vein and x-rays show up where the dye is present and where it isn't; i.e. where a clot is present.

Treatment of a DVT includes using blood thinner or anticoagulant medications that help decrease the ability of the blood to clot. Heparin is used initially until the clot is breaking up and then the individual is given warfarin or Coumadin that continues the process of blood thinning. Your body still has to break up the clot on its own, however. Blood thinners may be necessary for up to three months or more. In severe cases, clot busters are used to break up the clot and prevent the formation of a pulmonary embolus. Filters can be used to prevent pieces of the clot from breaking off and going to the lungs. Usually the filter is placed in the vena cava. Compression stockings are used to keep the swelling down and to keep flow going through your veins as much as possible.