Understanding Venous Thromboembolism

By Semko, Laura 
 | 
September 17, 2019

Understanding Venous Thromboembolism 

Venous thromboembolism is when a blood clot forms in a vein. The term refers to two linked conditions: deep vein thrombosis (DVT) and pulmonary embolism. If you have DVT, a blood clot has formed in a deep vein. It often happens in a leg. Sometimes this clot can break free and travel to your lungs. Once there, it can block blood flow. This is called a pulmonary embolism. It is a health emergency.

Front view of male figure with arrow showing path of blood clot from leg vein to lung, causing pulmonary embolism.

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What causes venous thromboembolism?

A blood clot can form in a vein for many reasons. The cause may be partly your genes. For example, you may have a protein deficiency or a blood-clotting disorder. Your family history may also make you more prone to the problem. 

Other things can also raise your chance for a blood clot in a vein. These include:

  • Major surgery, such as a joint replacement

  • Injury, such as a broken leg or damaged spinal cord

  • Cancer

  • Heart failure

  • Older age

  • Obesity

  • Smoking

  • Some medicines, such as birth control pills

  • Pregnancy

  • Long periods of not moving enough, such as after a surgery or on a long flight

Symptoms of venous thromboembolism

You may have no symptoms. But if you do, they can start quickly. Symptoms of DVT are:

  • Redness near the vein

  • Swelling

  • Pain

  • Changes in the color of the skin

A pulmonary embolism is a health emergency. It can cause trouble breathing, chest pain, coughing up of blood, and an irregular heartbeat. It may also cause sudden death.

Treatment for venous thromboembolism

The goal of treatment is to break up any blood clots and stop new ones from forming. A pulmonary embolism is then less likely to happen. Treatment includes: 

  • Blood thinners. These medicines may be given as a shot, through an IV, or in pill form. You may need to take them for a few months or longer. It depends on the cause of the blood clot.

  • Walking. Once your symptoms are under control,your healthcare provider may recommend that you walk. You may not be able to walk too far at first, such as after a surgery. But it will stop more blood clots from forming and help you feel better.

  • Compression socks. These socks or other similar devices can lower your risk for blood clots. They gently put pressure on the lower leg.

  • Inferior vena cava filter. This small metal deviceis put into your inferior vena cava. That’s the main vein that runs from your legs to your heart and lungs. It catches large clots before they reach these organs. It can stop a pulmonary embolism. You may need this treatment if you aren’t able to take blood thinners.

  • Surgery. In some cases, you may need surgery to remove a clot, especially if it has already reached the lungs. 

Possible complications of venous thromboembolism

  • New clots

  • High blood pressure in the arteries to the lungs (pulmonary hypertension)

  • Weak valves in a vein (post-thrombotic syndrome). This can cause cramping, pain, and swelling.

  • Bleeding

  • Death

When to call your healthcare provider 

Call your healthcare provider right away if you have any of these:

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Redness, swelling, or fluid leaking from your incision that gets worse

  • Pain that gets worse

  • Symptoms that don’t get better, or get worse

  • New symptoms

Updated:  

September 17, 2019

Sources:  

Guideline: Antithrombotic therapy for VTE disease: CHEST guideline and Expert Panel report. Kearon C, et al. ClinicalKey., Overview of the causes of venous thrombosis. Bauer KA. UpToDate., Overview of the treatment of lower extremity deep vein thrombosis. Lip GYH. UpToDate., Patient Education: Deep Vein Thrombosis (DVT) (Beyond the Basics). UpToDate., Surgical Critical Care. Stephen AH, Adams CA, Cioffi WG. Chapter 21. ClinicalKey.com., Venous Thromboembolism: Prevention, Diagnosis, and Treatment. Benrashid E. Vascular Surgery. ClinicalKey.com.

Reviewed By:  

Fetterman, Anne, RN, BSN,Sudheendra, Deepak, MD