Upper-extremity DVT: Don’t take it lightly

Deep-vein thrombosis (DVT) is a serious medical condition that occurs when a blood clot forms in one of the body’s deep veins, causing complete or partial blockage of blood flow. DVTs are grouped by location: upper extremity (upper body and arms) or lower extremity (legs). The biggest worry associated with DVTs is that pieces of the clot will break off and travel to the lung, causing a life-threatening pulmonary embolism.

Although about 85% of DVTs occur in the legs, increasing numbers of people are being diagnosed with upper-extremity DVTs.
 
What’s different about upper-extremity DVT?
A major risk factor for upper-extremity DVT is having a central venous catheter (a tube placed in the veins of the arms  or upper torso to administer drugs). In fact, doctors believe the increase in upper-extremity DVTs is happening because more people are getting chemotherapy and dialysis treatments administered through catheters. Placing catheters in veins can damage the vessels’ inner linings, increasing the risk of clot formation. Some upper-extremity DVTs are caused by lifting very heavy weights, pacemaker placement, accidental injury, and cancer.

DVTs can occur without any symptoms, but pain, swelling, and tenderness of the affected area are common. Symptoms specific to upper- extremity DVTs  include:

• vague shoulder or neck discomfort
• swelling of the arm or hand
• pain radiating to the arm/forearm
• hand weakness
• blurred vision, dizziness.

Diagnosis, prevention, and treatment
The first test used to diagnose upper-extremity DVTs is usually duplex ultrasonography, a noninvasive test that uses sound waves to create pictures of the veins. Other tests include contrast venography (which provides x-ray images of the veins) and magnetic resonance angiography (MRA).

Blood thinners are a treatment for upper-extremity DVTs, along with clot-busting medications. In some cases, surgery may be needed.