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 a condition that happens when a blood clot forms in a deep vein, usually in the leg. You can sometimes get DVT when sitting or lying down for long periods of time, such as during recovery from surgery or during a long airplane flight. When you don’t move enough, the blood flow in your legs slows down and pools. Blood clots can form in the pooled blood.
PE happens if the clot breaks off and travels through your bloodstream to your lungs. The clot can block a blood vessel in your lungs and cause damage to them.
Here’s a look at the symptoms of VTE, what to expect if you have it, medications and treatments you can try, and ways to prevent it.
According to the Centers for Disease Control and Prevention (CDC), about half of people with DVT don’t have symptoms. Any symptoms that do occur will be in the affected leg or the area where the clot is found. Symptoms can include:
If the clot moves into the lungs and you develop PE, you may have symptoms such as:
- chest pain, which may get worse when you breathe deeply or cough
- coughing up blood
- dizziness or even fainting
- rapid shallow breathing, or tachypnea
- rapid heartbeat
- irregular heartbeat
- shortness of breath
People with DVT and PE are often prescribed medication to stop the blood clot from getting bigger and to prevent more clots. There are a few different medications your doctor may prescribe.
Blood thinners (anticoagulants)
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 medications for three to six months. Your doctor may ask you to take them for a longer time period if you’ve had blood clots before.
Blood thinners can make you bleed too much when you get cut because they prevent your blood from clotting. Your doctor may test your blood to see how well it forms clots. The test results can help your doctor make sure you’re getting enough medication to prevent blood clots, but not so much that you bleed a lot.
If warfarin and heparin don’t help you or if you can’t take them for some reason, your doctor may prescribe a newer type of blood thinner called a thrombin inhibitor. Examples of thrombin inhibitors include:
- argatroban (Acova)
- bivalirudin (Angiomax)
- dabigatran (Pradaxa)
- desirudin (Iprivask)
- lepirudin (Refludan)
DVT and PE can also be treated with direct oral anticoagulants (DOACs). These are a newer type of drug that eliminates the need for routine blood test for monitoring. Another benefit of DOACs is that they may result in significantly fewer complications related to bleeding.
The thrombin inhibitor dabigatran is also a DOAC. Other examples of DOACs include:
PE is an emergency situation because it can block the airflow through your lungs. Your doctor may give you drugs called thrombolytics to break up the clot very quickly. You can only get this type of medication in a hospital, often in an emergency room.
You may get thrombolytics through a catheter. This is threaded right to the clot to break it up. Examples include streptokinase (Streptase) and urokinase (Kinlytic).
Your doctor may recommend a vena cava filter to address your DVT and PE.
In this treatment, your doctor inserts a filter inside the inferior vena cava. This 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.
According to the American College of Cardiology, interior vena cava filters should be limited to people with acute VTE who aren’t able to be anticoagulated.
If you have DVT, one big risk is that the clot may break free, go to a blood vessel in your lungs, and cause a PE. When a clot lodges in a blood vessel in your lungs, it can prevent enough air from traveling through your lungs and into your bloodstream. If the clot is big, it can completely block the air. This is life-threatening.
Sometimes the clot can also damage your venous valves and reduce blood flow. When this happens, it’s called post-thrombotic syndrome (PTS).
If you’ve had DVT in the past, you’re more likely to get it again after treatment.
Once you’ve had DVT or PE, the goal is to shrink the clot and prevent other clots from forming. Take any blood thinners your doctor prescribes and go to all follow-up appointments to make sure you don’t develop this condition again.
Your doctor can give you tips on preventing VTE. Here are a few examples:
- Avoid long periods of sitting. When you have to travel by plane or car, get up and walk around every hour or so to keep the blood flowing in your legs.
- Keep your legs uncrossed when seated to help your blood flow faster.
- Lose weight if you’re overweight. Ask a dietitian to help you create an eating plan for weight loss. Obesity increases your risk for DVT.
- Try to get more exercise. Staying active can prevent blood clots from forming.
- Quit smoking if you smoke. Smoking also increases the risk for DVT.
- Wear compression stockings. These put gentle pressure on your legs to prevent swelling and to keep your blood from clotting. They help prevent both DVT and PTS.