Deep vein thrombosis

To diagnose DVT, your health care provider will do a physical exam and ask questions about your symptoms. The provider will check the legs for swelling, tenderness or changes in skin color.

The tests you have depend on whether your provider thinks you are at a low or a high risk of DVT.

Tests

Tests used to diagnose or rule out DVT include:

D-dimer blood test. D dimer is a type of protein produced by blood clots. Almost all people with severe DVT have increased blood levels of D dimer. This test often can help rule out PE.

Duplex ultrasound. This noninvasive test uses sound waves to create pictures of how blood flows through the veins. It's the standard test for diagnosing DVT. For the test, a care provider gently moves a small hand-held device (transducer) on the skin over the body area being studied. Additional ultrasounds may be done over several days to check for new blood clots or to see if an existing one is growing.

Venography. This test uses X-rays and dye to create a picture of the veins in the legs and feet. The dye is injected into a large vein in the foot or ankle. It helps blood vessels show up more clearly on X-rays. The test is invasive, so it's rarely done. Other tests, such as ultrasound, often are done first.

Magnetic resonance imaging (MRI) scan. This test may be done to diagnose DVT in veins of the belly (abdomen).

There are three main goals to DVT treatment.

Prevent the clot from getting bigger.

Prevent the clot from breaking loose and traveling to the lungs.

Reduce the chances of another DVT.

DVT treatment options include:

Blood thinners. These medicines, also called anticoagulants, help prevent blood clots from getting bigger. Blood thinners reduce the risk of developing more clots.

Blood thinners may be taken by mouth or given by IV or an injection under the skin. There are many different types of blood-thinning drugs used to treat DVT. Together, you and your health care provider will discuss their benefits and risks to determine the best one for you.

You might need to take blood thinner pills for three months or longer. It's important to take them exactly as prescribed to prevent serious side effects.

People who take a blood thinner called warfarin (Jantoven) need regular blood tests to monitor levels of the drug in the body. Certain blood-thinning medications are not safe to take during pregnancy.

Clot busters (thrombolytics). These drugs are used for more-serious types of DVT or PE, or if other medications aren't working.

Clot busters are given by IV or through a tube (catheter) placed directly into the clot. They can cause serious bleeding, so they're usually only used for people with severe blood clots.

Filters. If you can't take medicines to thin your blood, a filter may be placed into a large vein — the vena cava — in your belly (abdomen). A vena cava filter prevents clots that break loose from lodging in the lungs.

Support stockings (compression stockings). These special knee socks help prevent blood from pooling in the legs. They help reduce leg swelling. Wear them on your legs from your feet to about the level of your knees. For DVT, you typically wear these stockings during the day for a few years, if possible.