The Doc Replies

Our expert answers your medical questions

What is Deep vein thrombosis?

Deep vein thrombosis (DVT) is a blood clot in a deep vein, usually the leg but sometimes the arm or abdomen. It’s more likely to occur if you are over 60, overweight, a smoker, if you have underlying cancer or heart failure, if you are on the contraceptive pill or pregnant, or have had a DVT before. It can also happen if you are immobile for some time, for example if someone has been on bed rest due to a recent operation or illness, or when travelling long distances. Symptoms can include a throbbing pain in the calf or thigh, usually on one side, swelling, the affected area can feel hot, the skin can change colour to become dark red and the veins may be swollen, hard and tender. Diagnosis includes a blood test called a D-dimer test and an ultrasound scan to show whether the blood is flowing through the veins. Treatment is blood-thinning medication, usually direct oral anticoagulants (DOACs) like rivaroxaban, generally taken for at least three months. You can get post DVT syndrome, where the leg remains swollen and sore so it is important to walk regularly, wear compression stockings and keep the legs elevated when sitting. Measures to prevent DVT include staying a healthy weight, avoiding crossing your legs when sitting, stopping to go for a walk during a long car journey, and walking about the plane and drinking plenty of water during a long flight.

What are key warning signs of a blood clot?

If you are more at risk, such as being older, overweight and confined to bed for some time or been on a long journey, it’s important to get any throbbing pain in the legs or arms checked out. Check for swelling of the limb, dusky red or purple skin and the skin feeling hot. Signs of a blood clot which has spread to the lung, a pulmonary embolism, include difficulty breathing, chest pain, faster or irregular heartbeat and coughing up blood, in which cases you should call 999 immediately.

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