How does DVT present?

A DVT is a blood clot that develops in the deep veins of the body, usually in the legs.

A patient will often present with pain and swelling in the affected leg, often the calf.
On examination the leg may be tender, warm to the touch and red.
It's important to diagnose a DVT, due to the risk of the clot breaking off and travelling in the bloodstream to the lungs, causing a pulmonary embolus (PE), which can be fatal.
Where a DVT has resulted in a PE, the patient is likely to be breathless and complain of chest pain, particularly when they breathe in.
There is also a risk of sudden collapse.

Where a patient presents with any of these symptoms or signs, it's important to take a detailed history to determine whether there are any risk factors to developing a DVT. This may include, for example, the oral contraceptive pill or hormone replacement therapy, obesity and immobility, either through illness or if the patient has been immobilised on a long journey or recently had surgery, such as a pelvic operation or hip replacement.

It's also important to check whether the patient has a past, or family, history of previous blood clots.

Not all patients will present with classic symptoms of a DVT and therefore a doctor's index of suspicion may be low. The patient may, for example, have a vague history of trauma which may lead the doctor to suspect the pain and/or swelling is mechanical. Another differential diagnosis may be that of a Baker's cyst; a fluid-filled swelling that can develop behind the knee causing similar symptoms of pain, swelling and tightness, as a DVT.

Spotting signs of DVT

Spotting signs of DVT