Deep vein thrombosis natural history

Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
The natural history of DVT is a dynamic process, with both thrombolysis and thrombus extension occurring after an episode of DVT. With the introduction of duplex scanning, several clinical studies have investigated and tried to clarify the natural history of DVT, the rate of recanalization of the thrombus, and the presence of reflux and its relation to lysis of the thrombus.

Natural History

 * Untreated proximal DVT
 * Clinical PE occur in 1/3rd to 1/2 patients.
 * Subclinical PE occurs in another 1/3rd.
 * Untreated PE tends to recur in days to weeks.


 * Post-phlebitic syndrome(10-30% of DVT)
 * pain, edema, skin discoloration, and ulceration associated with chronic venous insufficiency.

Death occurs in about 6 percent of DVT cases within one month of diagnosis.

According to a study done on 826 patients in Medical University of Vienna the risk of recurrence was almost four times as great among men as among women.

Complications
Proximal vein thrombosis is responsible for more than ninety percent of acute pulmonary embolism which has high mortality if not treated promptly.

The major outcomes of venous thrombosis are
 * Recurrence,
 * Post-thrombotic syndrome,
 * Major bleeding due to anticoagulation,
 * Death.

Thrombosis is also associated with impaired quality of life, particularly when post-thrombotic syndrome develops. Death occurs within one month of an episode in about 6% of those with DVT and 10% of those with PE

Ongoing Health Care Needs
Medicines that thin your blood and prevent blood clots are used to treat DVT. These medicines can thin your blood too much and cause bleeding (sometimes inside the body). This side effect can be life threatening.

Bleeding may occur in the digestive system or the brain. Signs and symptoms of bleeding in the digestive system include:


 * Bright red vomit or vomit that looks like coffee grounds
 * Bright red blood in your stools or black, tarry stools
 * Pain in your abdomen

Signs and symptoms of bleeding in the brain include:


 * Severe pain in your head
 * Sudden changes in your vision
 * Sudden loss of movement in your arms or legs
 * Memory loss or confusion

If you have any of these signs or symptoms, get treatment right away.