Deep Venous Thrombosis (DVT) & Thrombophlebitis

Most blood clots occur in the veins of the leg. About 10 to 15 percent occur in veins of the arms or elsewhere (neck, pelvis, chest wall). There are two types of blood clots: deep venous thrombosis (DVT) and superficial thrombophlebitis.

Superficial Thrombophlebitis

Superficial Thrombophlebitis is a clot in the veins outside the muscle just under the skin surface. This type of clot can occur spontaneously in a cluster of large varicose veins, or after a blood draw or IV. In general, superficial thrombophlebitis is not dangerous although it can be painful until it resolves. A superficial thrombophlebitis will feel like a hard, tender lump in the vein, or like a rope underneath the skin surface. Often the skin over the top of the vein is red and inflamed.

These clots are generally not dangerous although complications can occur:

  • Hyperpigmentation, or darkened skin after the clot is resolved
  • Infection–often accompanied by fever or shaking
  • Spread of the clot to the deep veins

Typically, the treatment is anti-inflammatory medication like ibuprofen, moderate activity, and warm compresses. Referral to a vascular specialist is often advised to discuss treatment of varicose veins to prevent future similar episodes. Although varicose veins are generally harmless, they can sometimes be a symptom of DVT.

Deep Venous Thrombosis (DVT)

Deep Venous Thrombosis (DVT) is a clot in the deep vein system. Such clots can dislodge and travel through the veins to the heart and lungs, causing a Pulmonary Embolism (PE). Although only a small number of DVT result in PE, it is fatal in 30 to 40 percent of cases. The main symptoms of DVT are a sudden swelling in one leg and a deep, persistent pain in the calf muscle or thigh muscle, sometimes compared to a charley horse. Sudden onset of chest pain or shortness of breath may be a sign of a pulmonary embolus. DVT can also cause permanent damage to the valves in the leg veins, resulting in pooling of blood in the legs known as Deep Venous Insufficiency, or DVI. Symptoms of DVI include edema (swelling), discoloration of the skin of the lower leg, and feelings of aching, throbbing, tightness, or engorgement in the legs. A third of people with DVT will develop Chronic Venous Stasis Disease (CVSD), skin damage which can lead to skin infection and ulcers.

The biggest concern about DVT is that a blood clot can dislodge and travel through the veins to the lungs, causing a PE, which in some cases is fatal. Sudden chest pain or shortness of breath may be a sign of a pulmonary embolus. DVT can also damage the valves in the leg veins, resulting in DVI, or pooling of blood in the legs. DVI produces permanent swelling and chronic damage to the skin.

If you suspect your varicose veins are caused by DVT, or if you have sudden swelling in one leg and shortness of breath, get help right away.

The diagnosis is as simple as a blood test or ultrasound. Standard treatment includes the use of blood thinners to stabilize the clot and prevent progression, but in some cases, a minimally invasive procedure can be performed to remove the blood clot.