Deep Vein Thrombosis (DVT) is a serious vascular condition where a blood clot (thrombus) forms in the deep veins, usually in the legs. If untreated, the clot can dislodge and travel to the lungs, causing a life-threatening pulmonary embolism (PE).

Incidence

More common in hospitalized, immobile, and post-surgical patients.
High risk in pregnancy, obesity, and smokers.
Annual incidence: ~1 in 1,000 people.

Definition

DVT is the formation of a blood clot in a deep vein, often in the legs or pelvis, leading to pain, swelling, and risk of embolization.

Etiology (Causes & Risk Factors)

1. Virchow’s Triad (Mnemonic: "VIS")

V – Venous Stasis (Prolonged immobility, bed rest, travel).
I – Injury to Vessel Wall (Surgery, trauma, IV catheters).
S – State of Hypercoagulability (Cancer, pregnancy, smoking).

2. Risk Factors (Mnemonic: "THROMBOSIS")

T – Trauma or surgery.
H – Hormonal therapy (Birth control, pregnancy).
R – Reduced mobility (Paralysis, long flights).
O – Obesity.
M – Malignancy (Cancer-associated hypercoagulability).
B – Blood disorders (Factor V Leiden, Protein C/S deficiency).
O – Old age (>60 years).
S – Smoking.
I – Infections or inflammatory conditions.
S – Stroke or previous DVT history.

Pathophysiology of DVT (Mnemonic: "CLOT")

C – Coagulation cascade activation leads to fibrin clot formation.
L – Loss of blood flow (stasis) promotes clot development.
O – Obstruction of venous return causes leg swelling & pain.
T – Thrombus can embolize → Pulmonary Embolism (PE).

Clinical Features (Mnemonic: "CLOTS")

C – Calf pain & swelling (unilateral).
L – Localized warmth & redness.
O – Obstruction of venous return → Heavy feeling in leg.
T – Tenderness along the deep vein.
S – Sudden breathlessness → Suspect Pulmonary Embolism (PE).

Signs of DVT

Homan’s Sign – Calf pain on dorsiflexion of the foot.
Pratt’s Sign – Tenderness on squeezing the calf.

Complications

Pulmonary Embolism (PE) – Clot breaks off and blocks lung arteries.
Post-Thrombotic Syndrome (PTS) – Chronic leg pain & swelling.
Venous Ulcers – Due to poor circulation.

Laboratory Investigations

1. Blood Tests

D-dimer test – High levels indicate clot breakdown (Sensitive but not specific).
Coagulation Studies (PT, APTT, INR) – Check for clotting disorders.

2. Imaging

Doppler Ultrasound (Gold Standard) – Detects vein blockage.
Venography – Most accurate but invasive.
CT Pulmonary Angiography (CTPA) – If PE is suspected.

Management of DVT

General Measures (Mnemonic: "WALK")

W – Wear compression stockings.
A – Avoid prolonged sitting or standing.
L – Leg elevation to improve circulation.
K – Keep moving (Early mobilization after surgery).

Allopathic Treatment (Mnemonic: "ABCs of DVT")

A – Anticoagulants (Heparin, Warfarin, Rivaroxaban).
B – Blood thinners (Low molecular weight heparin – LMWH).
C – Clot busters (Thrombolytics – Alteplase, Streptokinase) in severe cases.

Surgical Treatment

Inferior Vena Cava (IVC) Filter – Used if anticoagulation is contraindicated.
Thrombectomy – Surgical removal of clot (Rarely needed).

Homeopathic Treatment

5 Homeopathic Medicines with Symptoms

1. Hamamelis Virginiana

Engorged, painful veins with bruised sensation.
Varicose veins with burning pain.
Passive venous hemorrhages (bleeding easily from minor injury).
Pain in legs, worse from standing long hours.
Useful in both DVT and varicose veins.

2. Lachesis

Purplish discoloration of affected limb.
Symptoms worsen after sleep.
Intolerance to tight clothing.
Highly indicated in venous congestion and thrombosis.
Throbbing pains with marked restlessness.

3. Vipera Berus

Severe pain and swelling of veins.
Leg feels as if it will burst.
Relieved by keeping legs elevated.
Bluish, swollen veins with extreme tenderness.
Effective in deep vein thrombosis with risk of gangrene.

4. Arnica Montana

Painful swelling due to trauma or surgery.
Bruised, sore feeling in limbs.
Worse from touch, better with rest.
Prevents clot formation after injury.
Useful in preventing post-surgical thrombosis.

5. Fluoricum Acidum

Varicose veins with ulceration.
Burning pain, worse in warmth.
Weak veins that rupture easily.
History of venous insufficiency and clot formation.
Useful in chronic venous congestion.

Mnemonic for Homeopathic Treatment (HELP-V)

H – Hamamelis (Bruised veins, hemorrhage).
E – Elevation helps → Vipera Berus.
L – Lachesis (Purple discoloration, intolerance to tight clothing).
P – Painful, swollen veins → Arnica.
V – Varicose veins with ulcers → Fluoricum Acidum.

Deep Vein Thrombosis: Warning Signs, Prevention & Homeopathic Approach