When you first see the doctor, he or she will do a physical exam and ask questions about your medical history. These help your doctor decide what tests you need based on your risk for deep vein thrombosis (DVT).
Physical exam. Your doctor will check:
- Your heart and lungs.
- Your legs for warmth, swelling, bulging veins, or changes in skin color.
Medical history. Your doctor may ask:
- Do you have any swelling or pain in your legs?
- Have you had a blood clot before?
- What medicines do you take?
- Have you had surgery recently or have you been on any long trips lately?
Ultrasound test. Ultrasound is the main test used to help diagnose DVT. It creates a picture of the flow of blood through the veins.
If your doctor thinks you should have more tests, you might have two or three more ultrasounds over the next 7 to 10 days.
Additional tests. More tests may be used when ultrasound results are unclear. These tests often aren’t needed, but they may help diagnose or exclude a blood clot in the leg. These tests may include:
- D-dimer test.
- CT scan.
If your doctor thinks you might have a pulmonary embolism, he or she may test your lungs.
Blood thinner testing. If you are treated with anticoagulant medicines, you may need periodic blood tests to monitor the effects of the anticoagulant on the blood. Blood tests include:
- Activated partial thromboplastin time (APTT) to monitor treatment with heparin.
- Prothrombin time (PT), also referred to as INR, to monitor treatment with warfarin (Coumadin).
Tests for clotting problems. Special blood tests may help identify inherited blood-clotting problems that can increase your risk of forming blood clots or help explain why you got a blood clot. These tests check for genetic conditions or specific proteins in your blood.
Testing might be done if you have or had one or more of the following:
- A blood clot in a vein that has no clear cause
- A blood clot at age 45 or younger
- A blood clot in a vein at an unusual location, such as the gastrointestinal region, the brain, or the arms
- A first-degree family member (mother, father, brother, or sister) who has had a blood clot in a vein before age 45 or has had problems with blood clotting
Screening for these problems in the general population is not routinely done.
The main goals of treatment for deep vein thrombosis (DVT) are:
- To prevent the blood clot from becoming larger.
- To prevent the blood clot from traveling to the lungs (pulmonary embolism).
- To prevent post-thrombotic syndrome, a condition that can cause pain, sores, and swelling of the affected leg.
- To prevent blood clots from returning.
DVT is usually treated with anticoagulant medicines. These medicines are often called blood thinners, but they do not actually thin the blood. They prevent blood clots by increasing the time it takes a blood clot to form. Also, anticoagulants help prevent existing blood clots from becoming larger.
You might take anticoagulants for at least 3 months. The length of time will vary based on your own health, where the blood clot is in your leg, and your risk for a pulmonary embolism.