Team England’s Max Burgin, 20 years of age, has been forced to withdraw from the Birmingham 2022 Commonwealth Games. Initially it was thought that Max withdrew from his 800m heat in Oregon due to what was believed to be a calf strain in his right leg. After further investigation, it was revealed to be Deep Vein Thrombosis (DVT).
DVT is an abnormal blood clot which develops within a deep vein, usually in the leg or pelvis – and is believed to affect around 1 in every 1,000 people in the UK.
Large DVTs can move from the leg or pelvic veins and go through the venous system travelling into the heart and then lungs. This is called a pulmonary embolism (PE) which is a very serious medical condition and can even be fatal.
Although most DVTs are small, harmless and resolve by themselves, it is also true that a great many DVTs never get diagnosed and are often passed off by patients, doctors, and nurses as “muscle sprains” or other leg aches. Without a venous duplex ultrasound scan performed by a specialist vascular scientist (who is able to scan even the smallest veins in the calf), one cannot be certain as to whether a DVT is present or not.
The possible symptoms of Deep Vein Thrombosis can include:
DVT usually affects one leg, however it can rarely affect both.
In about half of patients, there are no symptoms or ‘warning signs’ and a DVT is only diagnosed if a complication occurs.
If people are ever uncertain as to whether they are suffering from DVT or any other venous condition, it is vital that they go and see a venous specialist as soon as possible so they can carry out a duplex ultrasound scan and advise on treatment.
In many Emergency Departments, a blood test called a D-Dimer test is performed, and if positive heparin is given whilst a duplex scan is organised. However, if a duplex ultrasound scan can be performed soon, this blood test is not needed.
If DVT is diagnosed and treated immediately, in the majority of cases the clot will be dissolved, and the vein will return to normal. If three is a delay in diagnosis and treatment, or if there are recurrent DVTs in the same leg, the deep veins can become scared and stop working properly. This causes “post-thrombotic syndrome” (PTS) which can cause chronic pain and swelling of the leg, with discolouration and often leg ulcers.
However, with very severe cases, the clot may have to be removed under X-ray control, although this is a very uncommon procedure currently.
It is also important to know why the clot has formed. This can be due to varicose veins, a compression in the veins, changes in the blood (dehydration, smoking and some drugs) or blood flow, or even a sign of other disease including abnormal blood clotting. Long flights and immobility are also contributory factors.
After the DVT has been diagnosed and treated, it is essential to look for the underlying cause and treat it, to reduce the risks of further DVTs in the future.