When worrisome symptoms appear, it can be hard to decide what to do—call your doctor, visit an urgent care clinic, or go to the emergency room (ER). Few people want to deal with an ER visit. It’s stressful, can take up a huge amount of time, and it can be costly. But there are times when the potentially life-saving care is the necessary choice. Developing a deep vein thrombosis (DVT) is one of those times.
Why is deep vein thrombosis an emergency?
DVT is a blood clot in a vein located deep in the body. Veins in the legs are the most common place for a DVT to develop. A blood clot in leg veins is an emergency because it can lead to life-threatening complications. The most dangerous of these problems is pulmonary embolism (PE). PE happens when the blood clot partially or totally breaks away and travels through the bloodstream to the lungs. It lodges in a blood vessel in the lungs, which blocks blood flow and can result in permanent lung damage. It can also permanently damage other organs due to lack of oxygen-rich blood. Left untreated, a PE can lead to shock, cardiac arrest, or death.
When is an emergency room visit necessary?
If you notice symptoms of DVT, it’s time to seek medical care. A PE can occur quickly or strike several days after a blood clot develops. Getting prompt treatment is the best way to prevent potentially devastating consequences. Common symptoms of DVT include:
Calf cramp or other leg cramps
Leg swelling or pain
Skin warmth or redness over the area
Do not delay care by going to an urgent care center. These centers can handle many acute injuries and sicknesses, but they aren’t able to manage life-threatening problems. Instead, go to the ER for a deep vein thrombosis emergency.
In some cases, DVT can develop without any obvious symptoms. You may not realize there is a problem until a PE happens. Seek immediate medical care (call 911) if you have symptoms of PE including:
Bluish lips or nails
Coughing up blood or bloody sputum
Lightheadedness
Shortness of breath or rapid breathing
What will happen at the emergency room?
In general, ER staff will triage—or prioritize—patients based on their symptoms and potential diagnosis. This lets doctors take care of the sickest people first. As a result, you may or may not have a wait. When you see the doctor, he or she will likely order some diagnostic testing. For DVT, the most common diagnostic test is a duplex ultrasound. This ultrasound combines sound waves and Doppler technology to visualize blood vessels and blood flow through them. If the doctor suspects a PE, other imaging exams will be necessary, such as a chest X-ray or CT scan.
People with DVT can often go home and complete treatment as an outpatient. You will need to follow-up with your personal doctor. However, having a PE usually means the ER staff will admit you to the hospital for aggressive medical therapy and close monitoring. This is especially true if your PE symptoms are severe.
How is deep vein thrombosis treated?
For DVT, medical treatment will stop the clot from growing, prevent a PE, and reduce the risk of future clots. This usually involves anticoagulant medicines, commonly known as blood thinners. The ER will likely give you an injectable anticoagulant. There are forms you can use at home once you leave the ER. This will continue for a few days while you start on blood thinners you take by mouth. There are also newer pill options that don’t require injectable medicines to get started.
You will continue an anticoagulant for several months. Your body will eventually break down the clot and absorb it. Your doctor may recommend wearing during this time to support blood flow.
Sometimes, more aggressive treatment is necessary for DVT. This includes clot-busting drugs—thrombolytics—to dissolve the clot or surgery to implant a vena cava filter. The filter will catch a clot before it can reach the lungs. Some DVT blood clots only require frequent monitoring with ultrasound.
In most cases, treatment of PE is similar to DVT treatment. Anticoagulants are the main treatment if your condition is not immediately life threatening. If the PE is more serious, doctors may use thrombolytics or a catheter-based procedure to remove the clot. Surgery to remove the clot may be necessary as a last resort
