Deep vein thrombosis is defined as an acute formation of a blood clot or thrombus within a vein resulting in obstruction of venous return.
Causes are unknown, but the triad of venous stasis, injury to vessel intima, and altered blood coagulability are central to the process.
- Prolonged bed rest for any reason
- Malignant disease
- Use of oral contraceptives
- Leg trauma
- Major surgery
- Infection after orthopedic surgery
- Acute myocardial infarction
- Old age (related to decreased activity)
- Symptoms may be subtle, variable, or vague
- Usually occurs in leg or deep pelvic veins (popliteal, femoral, iliac)
- Presence of one or more risk factors (see above)
- Recent leg injury
- Leg pain may be mild or absent
- Pain described as a dull ache or tightness, rarely severe
- Leg discomfort worse when walking
- Swelling of lower leg
Symptoms may be absent or minimal until shortness of breath and other pulmonary complaints appear because of embolism to the lungs. The risk of pulmonary emboli is low when only the calf veins are involved, but increases to 40% when the thigh veins are involved.
are variable; they depend on size and location of the clot and severity of the venous obstruction.
- Heart rate may be elevated
- Minimal to moderate distress
- Difficulty walking
- Minimal to marked swelling of lower leg
- Redness of affected calf or leg may be present
- Superficial leg veins may be distended
- Mild to moderate calf tenderness; flexion of the ankle may increase pain
- Localized warmth may be present
- Peripheral pulses (compare sides for symmetry)
Adapted from Clinical Practice Guidelines for Nurses in Primary Care. Cardiovascular System. Internet. Accessed on June 20, 2016.