Sometimes, blood vessel damage that occurs during surgery can cause a blood clot, particularly in operations on the lower half of your body. Conditions such as vasculitis inflammation of the blood vessels , varicose veins and some forms of medication, such as chemotherapy , can also damage blood vessels. Your risk of getting DVT is increased if you have a condition that causes your blood to clot more easily than normal.
These conditions include:. During pregnancy, blood clots more easily. It's the body's way of preventing too much blood being lost during childbirth. DVTs are also rare in pregnancy, although pregnant women are up to 10 times more likely to develop thrombosis than non-pregnant women of the same age. A clot can form at any stage of pregnancy and up to 6 weeks after the birth. Having thrombophilia a condition where the blood has an increased tendency to clot , or having a parent, or brother or sister, who's had a thrombosis, increase your risk of developing a DVT during pregnancy.
LMWH is an anticoagulant, which means it prevents the blood clot getting bigger. It's given by injection and doesn't affect your developing baby. The combined contraceptive pill and hormone replacement therapy HRT both contain the female hormone oestrogen. Oestrogen causes the blood to clot a bit more easily than normal, so your risk of getting DVT is slightly increased. There's no increased risk from the progestogen-only contraceptive pill.
Anticoagulant medicines prevent blood clots getting bigger. They can also help stop part of the blood clot breaking off and becoming lodged in another part of your bloodstream an embolism. Although they're often referred to as "blood-thinning" medicines, anticoagulants don't actually thin the blood. They alter proteins within it, which prevents clots forming so easily.
Heparin and warfarin are 2 types of anticoagulants that are used to treat DVT. After this initial treatment, you may also need to take warfarin to prevent another blood clot forming. The dose of standard unfractionated heparin to treat a blood clot varies significantly from person to person, so the dosage must be carefully monitored and adjusted if necessary.
You may need to stay in hospital for 5 to 10 days and have frequent blood tests to ensure you receive the right dose. LMWH works differently from standard heparin. It contains small molecules, which means its effects are more reliable and you won't have to stay in hospital and be monitored. In rare cases, heparin can also cause an extreme reaction that makes existing blood clots worse and causes new clots to develop.
This reaction, and weakening of your bones, is less likely to occur when taking LMWH. Warfarin is taken as a tablet. You may need to take it after initial treatment with heparin to prevent further blood clots occurring. Your doctor may recommend that you take warfarin for 3 to 6 months. In some cases, it may need to be taken for longer, even for life. As with standard heparin, the effects of warfarin vary from person to person.
You'll need to be closely monitored by having frequent blood tests to ensure you're taking the right dosage. When you first start taking warfarin, you may need to have 2 to 3 blood tests a week until your regular dose is decided. After this, you should only need to have a blood test every 4 weeks at an anticoagulant outpatient clinic. Warfarin can be affected by your diet, any other medicines you're taking, and by how well your liver is working. Warfarin isn't recommended for pregnant women who are given heparin injections for the full length of treatment.
Rivaroxaban comes in tablet form. It's a type of anticoagulant known as a directly acting oral anticoagulant DOAC. It prevents blood clots forming by inhibiting a substance called factor Xa and restricting the formation of thrombin an enzyme that helps blood clot. Treatment usually lasts 3 months and involves taking rivaroxaban twice a day for the first 21 days and then once a day until the end of the course.
Read the NICE guidance about rivaroxaban. Like rivaroxaban, apixaban is a DOAC that's taken orally as a tablet, and prevents blood clots forming by hindering factor Xa and restricting the formation of thrombin. Read the NICE guidance about apixaban. Wearing compression stockings helps prevent calf pain and swelling, and lowers the risk of ulcers developing after having DVT. They can also help prevent post-thrombotic syndrome. This is damage to leg tissue caused by the increase in venous pressure that occurs when a vein is blocked by a clot and blood is diverted to the outer veins.
After having DVT, stockings should be worn every day for at least 2 years. This is because symptoms of post-thrombotic syndrome may develop several months or even years after having a DVT. Compression stockings should be fitted professionally and your prescription should be reviewed every 3 to 6 months.
The stockings need to be worn all day but can be taken off before going to bed or in the evening while you rest with your leg raised. A spare pair of compression stockings should also be provided. Your healthcare team will usually advise you to walk regularly once compression stockings have been prescribed. This can help prevent symptoms of DVT returning and may help to improve or prevent complications of DVT, such as post-thrombotic syndrome.
As well as wearing compression stockings, you might be advised to raise your leg whenever you're resting. This helps to relieve the pressure in the veins of the calf and stops blood and fluid pooling in the calf itself. When raising your leg, make sure your foot is higher than your hip. This will help the returning blood flow from your calf. These problems are different for every patient — you may have all of these problems or only a few.
You may notice these problems all the time or the feelings may come and go. Many of the signs of PTS are the same as those for new blood clots in the leg, so it is very important for you to ask your health care provider to look at your leg. Only a health care provider can tell you if your problems are from a new blood clot or from PTS. Your health care provider will look at your leg and ask you some questions about how your leg feels. Then he or she will tell you if you have PTS.
You do not need any special scans or blood tests to find out if you have PTS. Since PTS can be such a long-term problem, prevention is very important. Here are some things you can do to prevent PTS:. Lose weight if you are overweight. Increased weight puts more strain on the legs and leg veins. Wear graduated elastic compression stockings. Wearing a special elastic stocking on the leg with the blood clot may help prevent PTS.
See your health care provider regularly. See your health care provider regularly Your health care provider can examine your leg at every appointment to look for signs of PTS.
He or she can also advise you about wearing elastic compression stockings and about taking your blood thinner medication correctly. PTS can be a difficult health condition to treat, so your health care provider may tell you to use one or all of these possible treatments:. Leg elevation. Often elevating your leg correctly can help with the pain and swelling from PTS. Your healthcare provider may prescribe either graduated compression stockings or a device worn on the leg or both to improve blood flow and control pain and swelling.
Some studies have shown that herbal supplements such as aescin horse chestnut extract and rutosides can be helpful in relieving leg pain and swelling caused by PTS, but this preparation has not been approved by the FDA. Your health care provider may recommend these supplements if compression stockings are not enough to help your leg pain and swelling. Special care for ulcers. If you get a leg ulcer because of PTS, you should see a special health care provider who has extra training in helping ulcers to heal.
That health care provider may give you special medications or bandages for the ulcer. It can often be difficult to tell whether your leg problems are caused by PTS or a new blood clot. Sometimes it takes months for your blood clot symptoms to get better. Because of this, the kidneys begin expelling diluted urine that does not possess sodium.
However, as your blood alcohol returns to normal, your body stops expelling water and starts accumulating it again. This results in water retention in the form of edema.
Pregnancy has many vexing effects on the body, not the least of which is water retention and swelling. Blood volume increases under the influence of pregnancy hormones, and downward pressure on the legs increases. This commonly results in edema of the lower legs. However, certain pregnancy complications, like preeclampsia and DVT, can also cause edema.
If you frequently suffer from edema during pregnancy, especially if you experience any symptoms of DVT or preeclampsia, talk with your doctor as soon as possible. What is venous thromboembolism? Centers for Disease Control and Prevention. Diagnosis and treatment of venous thromboembolism. Jameson JL, et al. Pulmonary thromboembolism and deep-vein thrombosis. In: Harrison's Manual of Medicine. McGraw Hill; Hull RD, et al. Biology of warfarin and modulators of INR control.
Blood thinner pills: Your guide to using them safely. Agency for Healthcare Research and Quality. Pruthi RK expert opinion. Mayo Clinic. Related Warfarin side effects. News from Mayo Clinic Mayo Clinic study provides clarity on use of anticoagulants in gastrointestinal cancers June 03, , p.
0コメント