Circulation Health
Peripheral Artery Disease: The Circulation Problem
Deep vein thrombosis — a blood clot forming in a deep vein, most often in the leg — is one of the most common serious vascular conditions in the developed world, affecting an estimated 900,000 Americans every year, according to the CDC.[1] It can cause lasting damage to the veins themselves, and its most dangerous complication — pulmonary embolism — is responsible for approximately 100,000 deaths annually in the United States. Yet DVT is frequently underdiagnosed because its symptoms mimic less serious conditions.
Deep vein thrombosis is a blood clot that forms in one of the large veins of the leg, thigh, or pelvis. It is the third most common cardiovascular emergency, after heart attack and stroke. What makes DVT particularly dangerous is that it often causes minimal symptoms in its most threatening form, and when it does cause symptoms, those symptoms are easy to attribute to something else entirely.
Blood clots form when three conditions are present, a framework called Virchow's Triad: reduced blood flow velocity, damage to the vessel wall, and increased blood coagulability.[2] Long periods of immobility such as bed rest or long flights slow venous blood flow in the legs. Surgery, injury, or inflammation damages vessel walls. Certain medical conditions, hormonal medications, dehydration, and genetic clotting disorders increase coagulability.
The deep veins of the lower extremity, particularly the popliteal, femoral, and iliac veins, are the most common sites of clot formation. Smaller clots confined to calf veins are less immediately dangerous but can extend proximally over days if untreated.
The reason DVT commands such clinical urgency is its relationship to pulmonary embolism. When a clot breaks free from its site of origin in the leg, it travels through the venous system, into the right side of the heart, and then into the pulmonary arteries supplying the lungs. Large pulmonary emboli obstruct blood flow through the lungs, cause acute right heart strain, and can be rapidly fatal.
Pulmonary embolism kills approximately 100,000 Americans annually. Many of these deaths are preceded by DVT that was symptomatic but not evaluated. If you have leg swelling, warmth, or pain that persists beyond a day or two, particularly after a period of immobility, this warrants same-day evaluation.
Classic DVT symptoms include unilateral leg swelling, warmth, redness along the course of a vein, and aching or heaviness in the calf or thigh. However, up to half of DVT cases are completely asymptomatic. And when symptoms are present, they closely mimic other conditions such as muscle strain, cellulitis, Baker cyst, and venous insufficiency. Clinical examination alone misses DVT in approximately 30 percent of cases.
This is why venous duplex ultrasound is the first-line diagnostic test for suspected DVT. It has greater than 95 percent sensitivity for proximal DVT and directly visualizes thrombus in the vein lumen.[3] The test takes 45 minutes, involves no radiation, and can be performed in your home.
BlackPoint performs lower extremity venous duplex ultrasound at your home with full compression and Doppler evaluation of all major deep and superficial venous segments. Results including written cardiologist report are delivered within 24 to 48 hours. $397, no referral required.
Book your screening or reach out with any questions about your cardiovascular health.
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