DVT & Blood Clots

Blood clots in the veins are fairly common, and the risk goes up with age. Many happen during or after a hospital stay or surgery.

• DVT: a clot in a deep vein, most often in the leg.
• Pulmonary embolism (PE): a clot that has traveled to the lungs. This is an emergency.
• Superficial thrombophlebitis: a clot in a vein just under the skin. It causes a red, tender, hard vein. It is usually less dangerous but still needs to be checked.

• Surgery, especially hip or knee surgery, or a recent hospital stay
• Not moving for long periods, such as bed rest or long car or plane trips
• Cancer and some cancer treatments
• Pregnancy and the weeks after giving birth
• Birth control pills or hormone therapy with estrogen
• A past blood clot, or a family history of clots
• Injury to a vein, such as a broken bone
• Smoking, obesity and getting older
• Inherited clotting disorders

About half of people with a DVT have no symptoms. When there are signs, they usually affect one leg:

• Swelling in one leg, ankle or foot
• Pain, cramping or soreness, often starting in the calf
• Warm skin over the painful area
• Red or darker skin color on the leg
• Veins near the skin that look bigger than usual
• Signs of a PE: sudden shortness of breath, chest pain that gets worse with a deep breath, a fast heartbeat, coughing up blood, or feeling faint
• At your visit, your provider compares both legs, measures the size of each calf, checks for tenderness along the deep veins, swelling that leaves a dent, warmth and skin color, and checks your heart rate, breathing and oxygen level.

Your provider uses your history and exam to estimate how likely a clot is. Clinicians often use a scoring tool called the Wells criteria for this.

A blood test called a D-dimer can help rule out a clot when the chance is low.

A venous duplex ultrasound is the main test to find a DVT. If a PE is possible, a CT scan of the chest may be needed. We don't do imaging at our office; we send you to an imaging center right away, or, if a clot in the lungs is possible, you need emergency care or 911.

These tools are used by clinicians. Bring your results to your visit; they don't replace a medical evaluation.

• Wells' Criteria for DVT ↗ (opens in a new tab)Helps clinicians judge how likely a swollen leg is caused by a blood clot.
• Wells' Criteria for Pulmonary Embolism ↗ (opens in a new tab)Helps clinicians judge how likely a clot in the lungs is.

Treatment stops the clot from growing and lowers the chance of a new one. Your plan may include:

• Blood thinners (anticoagulants), usually for at least 3 months. Common ones include Eliquis (apixaban) and Xarelto (rivaroxaban). Some people need warfarin or injections.
• Taking your blood thinner exactly as prescribed, and telling every provider and dentist that you take it.
• Walking as soon as your provider says it's OK.
• Compression stockings to ease swelling and pain for some people.
• Hospital care and stronger treatments for a large PE or a very large clot.
• To prevent clots: move around often on long trips, stay active, and ask about clot prevention before surgery.

With treatment, most DVTs get better over weeks to months. Swelling and pain usually ease.

Some people have lasting leg swelling, aching or skin changes, called post-thrombotic syndrome. Clots can come back, so your provider will talk with you about how long to stay on a blood thinner.

Your primary care team at Moaddel Medical checks you quickly for a possible clot, orders lab tests and urgent ultrasound, and starts or manages blood thinners when appropriate.

We follow up on your treatment, help lower your risk of another clot and refer you to vascular or hematology specialists when needed.

We're at 7230 Medical Center Dr, Suite 100, West Hills, CA 91307.