Deep Vein Thrombosis – DVT

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) is a blood clot in one of the deep veins inside your leg. A DVT usually affects
one leg; it is a serious condition and needs urgent investigation and treatment.

What is a DVT?

DVT occurs when a clot forms in the deep vein, most commonly in the leg but it can occur in other veins
too. This may cause the vein to become partially or completely blocked.

What are the causes?

A blood clot develops when the blood cells stick together. There are 3 factors that may trigger a clot to form in a vein:

• Reduced blood flow
• Changes in the clotting mechanism of the blood
• Changes to the smooth lining of the blood vessel.

Who is at risk to developing a DVT?

You are more likely to develop a DVT if you have any of the following risk factors:

• Aged over 40
• Had a previous Blood clot
• Family history of blood clots
• Existing health problems e.g Cancer or blood disease
• Recent surgery or illness causing immobility
• Pregnancy, contraceptive pill or Hormone replacement therapy.
• Overweight
• Extended Travel

Some people do not have any of the above risk factors but can still develop a DVT.

What are the signs and symptoms of DVT?

Symptoms may include:

• Pain in the calf
• Swelling
• Tenderness
• Redness or discolouration
• Difficulty with weight bearing

Investigations

You will be assessed by a specialist DVT Nurse; if necessary a Doppler Ultrasound scan of your
leg will be arranged.

If the scan is Negative and no DVT is found no treatment is required.

Why is DVT a cause for concern?

A serious complication of DVT is pulmonary embolism (PE) which is when the blood clot or part of it can
break off and travel to the lung

Symptoms of a PE may include:

• Shortness of breath
• Pain in the chest or ribs
• Difficulty in breathing
• Dizziness
• Coughing up blood

If you suspect you have a PE you should seek urgent medical attention or dial 999. PE is not common
but can be life threatening.

Treatment

The treatment works to thin the blood and make it more difficult for the blood to clot. It is usually provided
by either:

• Tablets called Rivaroxaban®. Taken once a day for the duration of the plaster cast or splint.
  Rivaroxaban works immediately and does not require any additional blood tests.
• Injections called Clexane®. These require an injection under the skin every day.

Research studies tell us that both treatments are equally effective and safe for the treatment of DVT and
PE. For most patients, taking a tablet is less painful, easier and more convenient than having daily
injections. Therefore Rivaroxaban is often the preferred option. However some people cannot take
Rivaroxaban®, these include:

• Children
• Pregnant and breast feeding ladies or recently given birth
• People with poor kidney function.
• People who have had a bleed from their gut
• People who have cancer or a receiving chemotherapy
• People who require warfarin for other reasons, except atrial fibrillation.

Treatment Side Effects and Important Advice

Blood thinning treatment of any kind will make you more likely to bleed and bruise after simple bumps, cuts
or scrapes. Simple first aid measures can be used in most cases by applying pressure to a bleeding area
and elevating it if possible. Pressure should be firm, and in some cases may need to be applied for at least
20 minutes or longer.

If you happen to injure your head (eg. fall over) whilst taking either Clexane® or Rivaroxaban®, please
seek medical advice from NHS111, your GP, local minor injuries unit or A&E department.

• Clexane® may cause bleeding and bruising under the skin as well as redness and irritation at the
  injection site. Clexane® has been used now for many years and there are no other long term side-effects.

• Rivaroxaban® may cause headaches, rashes and itches (a full list of side-effects can be found on
  the information leaflet in the box or by asking your doctor / nurse / pharmacist). Rivaraoxban® is a
  relatively new treatment and has only been in use for a few years; we therefore do not know if the
  drug has any other side-effects and we have less experience in using it for the prevention of clots
  in the lungs or legs compared to Clexane®.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved
ones. If you have any questions or concerns, please do speak with a member of staff on the ward or
in the relevant department who will do their best to answer your questions and reassure you.

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where
improvements can be made. There are lots of ways you can share your experience with us including
completing our Friends and Family Test – cards are available and can be posted on all wards,
departments and clinics at our hospitals. We value your comments and feedback and thank you for
taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge
or the department manager in the first instance as they are best placed to answer any questions or
resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you
can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital
services & experiences.
Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel
unable to do so, to resolve your problems and where appropriate refer to outside help.
If you are still unhappy you can contact the Complaints Department, who can investigate your
concerns. You can make a complaint orally, electronically or in writing and we can advise and guide
you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that
you may need to leave a voicemail message, but we aim to return your call within one working day.
If you are unable to understand this leaflet, please communicate with a member of staff.

For additional medical advice, if your symptoms or condition worsens:

• Contact your GP
• NHS 111: Telephone 111
• Get help with your symptoms, NHS111: https://111.nhs.uk/
• Information to help you manage your health: www.nhs.uk
• In an emergency telephone 999

Emergency Department (A&E)
Alexandra Hospital
Woodrow Drive
Redditch B98 7UB
Tel: 01527 512030

Minor Injury Unit
Kidderminster Hospital
Bewdley Road
Kidderminster DY11 6RJ
Tel: 01562 513039

Emergency Department (A&E)
Worcestershire Royal Hospital
Charles Hastings Way
Worcester WR5 1DD
Tel: 01905 760743

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