Venous thromboembolism (VTE) is a blood clot that starts in a vein. Blood clots occur when your blood thickens and blocks flow through a vessel.
At Seattle Cancer Care Alliance (SCCA), our team of experts provides comprehensive diagnostic and medical care for people who’ve had venous thromboembolism. SCCA hematologists work closely with all of our doctors to care for people who are at risk, including people being treated for cancer or bone marrow disorders.
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What is venous thromboembolism?
VTE is an umbrella term that includes two conditions: Deep vein thrombosis (DVT) and pulmonary embolism (PE).
DVT is a blood clot that forms in a vein deep in your body. It happens most often in the lower leg or thigh but can happen in other parts of the body as well.
DVT can occur for several reasons, including damage to a vein, such as from a fracture or surgery, or slow blood flow, such as from lying in bed or sitting for long periods. Other risk factors include:
- Being pregnant
- Taking birth control pills or hormone replacement for menopause
- Being overweight
- Having cancer
- Having an inherited condition that increases your tendency to form clots or decreases your ability to dissolve them
Many patients with DVT have more than one risk factor, but some patients can have DVT without any known risk factors.
If a blood clot in a deep vein breaks loose, it can travel through your bloodstream. A clot that’s moving is called an embolus. Clots in veins travel toward your lungs. If a clot reaches your lungs and blocks blood flow there, the condition is called pulmonary embolism (PE). PE can damage your lungs or be fatal.
Symptoms and diagnosis of venous thromboembolism
Not everyone with DVT has symptoms. When symptoms do arise, they may include:
- Swelling of the leg
- Pain or tenderness in the leg, often similar to the symptoms of a muscle cramp (or injury) that does not resolve
- Increased warmth in the area
- Red or discolored skin
Typically, DVT affects only one leg at a time, not both.
PE symptoms include:
- Shortness of breath
- Fast heart rate or breathing
- Chest pain, made worse by taking a deep breath or coughing
- Coughing up blood
- Feeling lightheaded or fainting
To diagnose venous thromboembolism, your doctor will examine you and ask about your health history and family history. You will have blood tests to check your clotting activity, and you may need an imaging test, such as an ultrasound of your leg for DVT or a computed tomography (CT) scan of your lungs for PE.
Venous thromboembolism treatment
Both DVT and PE are serious conditions that can damage your lungs and other organs. They need medical treatment right away.
The usual treatment is anti-clotting medicine (anticoagulants) — such as heparin, enoxaparin (Lovenox), apixaban (Eliquis), dabigatran (Pradaxa), rivaroxaban (Xarelto), edoxaban (Savaysa) and warfarin (Coumadin) — given by injection or taken in tablet form. Doctors can also give medicines that dissolve clots (thrombolytics) into your bloodstream or even directly into a clot. Some people need surgery in order to inject medicine into a clot, remove a clot or place a filter in a vein to keep clots from reaching the lungs.
After the first few months of treatment for DVT or PE, the decision about whether to continue anti-clotting medicine can be complex. Venous thromboembolism experts at SCCA can provide information and advice to help you decide about ongoing treatment.