Venous thromboembolism (VTE) is a disease that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT and PE are both forms of VTE, but they’re not the same thing.
- DVT is when a blood clot forms in a deep vein, usually in the leg.
- PE happens if a clot breaks off and travels through the bloodstream to your lungs. Once in the lungs, the clot can block a blood vessel in your lungs. Usually, PE is much more dangerous than DVT.
Call your doctor right away if you notice any of these symptoms. Symptoms of a new blood clot typically include:
- swelling, pain, or redness in your leg
- shortness of breath
- coughing (sometimes with blood)
- chest pain that gets worse when you cough
Here’s a look at the medication and treatment options available for VTE.
Blood thinners are medications that make your blood less likely to clot. An anticoagulant is a type of blood thinner that slows blood clotting. Two types of anticoagulants are warfarin (Coumadin) and heparin. You can take blood thinners as a pill by mouth, through an injection, or intravenously. Most people with DVT take these medicines for three to six months, but your doctor may ask you to take them for a longer time period if you’ve had blood clots before.
Heparin is typically the first blood-thinning drug doctors prescribe to people with DVT.
Heparin comes in two forms:
Unfractionated heparin is a very strong blood thinner that starts to work quickly. You’ll get this drug in a hospital intravenously. Because unfractionated heparin can cause severe bleeding, doctors and nurses will keep a close eye on you while you take it, which includes frequent blood tests.
Low Molecular Weight Heparin (LMWH)
Low molecular weight heparin (LMWH) is administered as an injection that you can give yourself at home. Types of LMWH include:
- dalteparin (Fragmin)
- enoxaparin (Lovenox)
- tinzaparin (Innohep)
Of these, Lovenox is currently the most widely used in U.S. hospitals. LMWH is not as strong as unfractionated heparin, so you don’t need to be monitored as closely while on it.
Generally, you’ll be treated with heparin for about five to seven days. Meanwhile, your doctor will most likely start you on warfarin (Coumadin), which you take as a pill by mouth. After the five to seven days, you’ll discontinue heparin and stay on warfarin for a few months.
Warfarin isn’t your only option when it comes to an oral anticoagulant. Your doctor might instead prescribe one of these medicines:
- apixaban (Eliquis)
- dabigatran (Pradaxa)
- edoxaban (Savaysa)
- rivaroxaban (Xarelto)
Most people with DVT take anticoagulants for three to six months. You might take them for a longer duration if you’ve had blood clots before, or if you’re at serious risk for a clot because of a mechanical heart valve or other health issue. If you developed a blood clot after surgery, you might not need to take blood thinners for as long.
The biggest side effect from anticoagulants is bleeding. Your doctor will give you periodic tests to see how well your blood clots. These tests will make sure you’re getting just enough medicine to prevent blood clots but not enough to make you bleed too much.
If anticoagulants don’t help your DVT, or if the blood clot has moved into your lungs, you’ll most likely get emergent treatment within the hospital setting.
Thrombolytics are a type of drug that can break up clots very quickly. You can only get this type of medication in a hospital, often in an emergency room or a cardiac-monitored hospital bed. You may get thrombolytics through a flexible tube called a catheter, which is threaded right to the clot to break it up.
Vena Cava Filter
In this treatment, your doctor inserts a filter inside the inferior vena cava, which is a large vein that carries blood from your body back to your heart. The filter doesn’t stop clots from forming, but it can catch clots that form before they travel to your lungs.
In rare cases, people who are at risk for more blood clots might need surgery.
When you have a blood clot, the biggest worry is that it will break free and get lodged in a blood vessel in your lung, causing a PE. If this happens and the clot is very large, it can cut off your oxygen supply. This complication can be life-threatening or fatal.
Sometimes the clot can also damage your venous valves and reduce blood flow. When this happens, it’s called post-thrombotic syndrome.
DVTs may also recur after initial treatment. Because of these risks, you’ll want to schedule regular visits with your doctor and be aware of symptoms.