Although less common than in many other parts of the world, the number of people developing deep vein thrombosis (DVT) in Singapore is on the increase. Developing a blood clot in one of the deep veins is not only painful, but it can lead to serious complications. However, by recognizing the symptoms of DVT and seeking help early, this reduces the chance of lasting problems. Similarly, understanding the risk factors for blood clot formation and taking precautions can help you to minimize your chance of developing a clot.
UNDERSTANDING DEEP VEIN THROMBOSIS
WHAT IS DEEP VEIN THROMBOSIS?
The most common site for DVT is in one of the veins deep within your legs. Blood clots develop here when your blood thickens and forms a clump. If a blood clot from a deep vein breaks free and reaches the lungs, it may block an artery in the lungs. This is known as a pulmonary embolism and can lead to organ damage and even death. Together DVT and pulmonary embolism are termed venous thromboembolism.
WHO ARE AT RISK?
The following all increase your risk of a blood clot developing in your leg veins:
- Inactivity, whether due to injury, ill-health or a long journey, reduces blood flow through the veins in your legs.
- Damage to your leg veins. This may occur due to an injury, during surgery or as a consequence of phlebitis (inflammation).
- Certain medical conditions such as heart disease, cancer, inflammatory conditions and blood clotting disorders.
- Pregnancy.
- Using the combined contraceptive pill or HRT, as both contain estrogen, which stimulates blood clotting.
- Being overweight.
- Smoking.
- Dehydration.
- Advancing age, as blood clots are more likely among the over 60s.
WHAT ARE THE SIGNS AND SYMPTOMS?
Although not everyone who develops a DVT has symptoms, there are several characteristic signs of a blood clot in one of the deep veins in your legs. It is typical to experience pain, often described as a heavy ache, in your calf; this pain may worsen when you flex your foot upwards. The affected leg is usually swollen as well. However, if both legs are sore or you have swollen legs, this will usually have another cause, as it is very unusual to have a blood clot in both legs at the same time. The skin of your lower leg may also appear red and feel warm to the touch.
If a blood clot in your leg is untreated and a pulmonary embolism occurs, you will develop more severe symptoms. Sudden breathlessness, chest pain and collapse are all common in venous thromboembolism affecting the lungs.
HOW IS IT DIAGNOSED?
Your symptoms provide a clue that you may have a thrombosis in a deep leg vein, but specialist tests are essential to confirm this diagnosis. A blood test, called a D-dimer test, identifies loose pieces of blood clot and the more fragments detected, the greater the likelihood of a venous thrombosis. However, as this is not 100% accurate, you also need an ultrasound scan. This detects the presence of a blood clot in a vein and can also give details about the rate of blood flow, showing whether it flows at a reduced rate or blood flow has been completely blocked. If there is still uncertainty about the presence of a blood clot, a venogram is necessary. For this test an X-ray shows whether an injected dye is able to flow from your foot through your leg veins.
WHAT IS THE TREATMENT?
If you have a DVT, you will usually receive an injection of sclerosant; this is anticoagulant medication, which stops your blood clot growing in size and breaking off. You will usually be given compression stockings to wear as well, which reduce pain and swelling. These compression stockings also reduce your risk of ulcers and post-thrombotic syndrome after a thrombosis in your deep leg veins. The latter can occur months or even a year after the blood clot, causing damage to the tissue within your lower legs, so wearing these supports for two years post-DVT is advisable for this reason. Raising your affected leg is another way to reduce swelling.
HOW CAN I PREVENT IT?
Making changes to your lifestyle is one of the best ways to reduce the likelihood of developing a thrombosis. Taking regular exercise, quitting smoking, eating a balanced diet and losing excess weight all protect you against blood clot formation. However, if you are travelling a long distance by car, train or plane, it is important to take additional precautions. Keeping well-hydrated, performing leg stretches, taking short walks when possible and wearing compression stocking are all advisable when going on a long journey, particularly if you are at increased risk of a DVT.
As operations and certain medical procedures increase the risk of a blood clot forming, your healthcare team will additionally take measures to protect you against DVT; this may involve stopping certain medications before treatment, taking anticoagulants or using compression stockings.
DR TAN IN THE NEWS
Dr. Tan perform EVLT procedure Channel Newsasia 2009
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Venaseal Treatment
Understanding Deep Vein Thrombosis
Although less common than in many other parts of the world, the number of people developing deep vein thrombosis (DVT) in Singapore is on the increase. Developing a blood clot in one of the deep veins is not only painful, but it can lead to serious complications. However, by recognizing the symptoms of DVT and seeking help early, this reduces the chance of lasting problems. Similarly, understanding the risk factors for blood clot formation and taking precautions can help you to minimize your chance of developing a clot.
What is Deep Vein Thrombosis?
The most common site for DVT is in one of the veins deep within your legs. Blood clots develop here when your blood thickens and forms a clump. If a blood clot from a deep vein breaks free and reaches the lungs, it may block an artery in the lungs. This is known as a pulmonary embolism and can lead to organ damage and even death. Together DVT and pulmonary embolism are termed venous thromboembolism.
Who Are At Risk?
The following all increase your risk of a blood clot developing in your leg veins:
- Inactivity, whether due to injury, ill-health or a long journey, reduces blood flow through the veins in your legs.
- Damage to your leg veins. This may occur due to an injury, during surgery or as a consequence of phlebitis (inflammation).
- Certain medical conditions such as heart disease, cancer, inflammatory conditions and blood clotting disorders.
- Pregnancy.
- Using the combined contraceptive pill or HRT, as both contain estrogen, which stimulates blood clotting.
- Being overweight.
- Smoking.
- Dehydration.
- Advancing age, as blood clots are more likely among the over 60s.
What Are The Signs And Symptoms?
Although not everyone who develops a DVT has symptoms, there are several characteristic signs of a blood clot in one of the deep veins in your legs. It is typical to experience pain, often described as a heavy ache, in your calf; this pain may worsen when you flex your foot upwards. The affected leg is usually swollen as well. However, if both legs are sore or you have swollen legs, this will usually have another cause, as it is very unusual to have a blood clot in both legs at the same time. The skin of your lower leg may also appear red and feel warm to the touch.
If a blood clot in your leg is untreated and a pulmonary embolism occurs, you will develop more severe symptoms. Sudden breathlessness, chest pain and collapse are all common in venous thromboembolism affecting the lungs.
How Is It Diagnosed?
Your symptoms provide a clue that you may have a thrombosis in a deep leg vein, but specialist tests are essential to confirm this diagnosis. A blood test, called a D-dimer test, identifies loose pieces of blood clot and the more fragments detected, the greater the likelihood of a venous thrombosis. However, as this is not 100% accurate, you also need an ultrasound scan. This detects the presence of a blood clot in a vein and can also give details about the rate of blood flow, showing whether it flows at a reduced rate or blood flow has been completely blocked. If there is still uncertainty about the presence of a blood clot, a venogram is necessary. For this test an X-ray shows whether an injected dye is able to flow from your foot through your leg veins.
What Is The Treatment?
If you have a DVT, you will usually receive an injection of sclerosant; this is anticoagulant medication, which stops your blood clot growing in size and breaking off. You will usually be given compression stockings to wear as well, which reduce pain and swelling. These compression stockings also reduce your risk of ulcers and post-thrombotic syndrome after a thrombosis in your deep leg veins. The latter can occur months or even a year after the blood clot, causing damage to the tissue within your lower legs, so wearing these supports for two years post-DVT is advisable for this reason. Raising your affected leg is another way to reduce swelling.
How Can I Prevent It?
Making changes to your lifestyle is one of the best ways to reduce the likelihood of developing a thrombosis. Taking regular exercise, quitting smoking, eating a balanced diet and losing excess weight all protect you against blood clot formation. However, if you are travelling a long distance by car, train or plane, it is important to take additional precautions. Keeping well-hydrated, performing leg stretches, taking short walks when possible and wearing compression stocking are all advisable when going on a long journey, particularly if you are at increased risk of a DVT.
As operations and certain medical procedures increase the risk of a blood clot forming, your healthcare team will additionally take measures to protect you against DVT; this may involve stopping certain medications before treatment, taking anticoagulants or using compression stockings.
Dr. Tan perform EVLT procedure Channel Newsasia 2009
Dr. John Tan featured in MediaCorp Channel 8 (早安您好)
Dr. John Tan featured in Channel NewsAsia Primetime Morning