Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Deep Vein Thrombosis

A Deep Vein Thrombosis (DVT) is a clotting of the blood in any of the deep veins – usually in the calf. If a clot develops, it usually makes its presence known by an intense pain in the affected calf. Medical attention should be sought immediately if this occurs, especially after a long journey. In some cases this can be fatal, if the clot breaks off and makes its way to the lungs where it can then affect the lung’s ability to take in oxygen. A DVT can occur some days or even weeks after a trip.

Is a deep vein thrombosis serious?

When a blood clot forms in a leg vein it usually remains stuck to the vein wall. The symptoms tend to settle gradually, but there are 2 main possible complications.

What is Travel Related Deep Vein Thrombosis?

“Economy Class Syndrome” is a term used to describe the swollen and aching legs that air or some car travelers observe during long trips. It may be associated with a serious leg condition called deep vein thrombosis (DVT) through venous obstruction.
Each year, DVT occurs in about one in every 1,000 people in the general population and in up to one-third of people who have had major surgery. Scientific study to quantify the risk of DVT posed by air travel – although it is suspected to be small in most people – is on-going.
While the problem is often associated with air travel, the risk is equally reported among those traveling by car, coach and train.

Who is at risk?

Most cases have at least 3 predisposing risk factors – the risk increases as risk factors increase. Very little established research exists in relation to travel. However we do have a wealth of information from hospital research specific to DVT.

We already know that the following factors increase the risk of travel related DVT:
  • Immobility for an extended period of time
  • Over 40 years of age
  • Who have had blood clots already
  • Suffering from or who have had treatment for cancer
  • Who have had recent surgery especially on the hips or knees
  • Existing clotting abnormality or inherited clotting tendency
  • Overweight and obesity
  • Chronic illnesses
  • Hormones or the oral contraceptive pill
  • Varicose veins
  • Pregnancy or 2 months post-partum
  • Being treated for heart failure and circulation problems
  • Dehydration

How is DVT diagnosed?

DVT/PE is undiagnosed and misdiagnosed more often than not. Diagnosis usually involves a special type of ultrasound scan of the leg called a duplex ultrasound. If this test does not show a DVT but the doctor still suspects a DVT based on the symptoms, then further tests such as venography may be carried out. Venography uses an X-ray image to track the distribution of a special dye injected into the deep veins of the leg.

What are the symptoms of DVT?

  • Leg symptoms (Deep Vein Thrombosis, DVT) may appear during flight or in the next few days.
  • Sudden swelling in one lower leg (A little swelling in both legs is normal in flight).
  • Cramp or tenderness in one lower leg
  • Bruise or swelling behind knee
  • Chest symptoms (Pulmonary Embolism, PE) usually appear 2-4 days or more after the initial blood clot, which you may not have noticed:
    • Shortness of breath
    • Rapid breathing, panting
    • Cramp in your side, painful breathing
    • Chest pain accompanied by shoulder pain
    • Fever
    • Coughing up blood
    • Fainting (often the first sign, especially in older people)