Summary about Disease
Upper Extremity Deep Vein Thrombosis (UEDVT) is a blood clot that forms in a deep vein of the arm, shoulder, or neck. It is less common than deep vein thrombosis (DVT) in the legs but can have serious consequences, including pulmonary embolism (PE), a life-threatening condition where the clot travels to the lungs.
Symptoms
Symptoms of UEDVT may include:
Swelling in the arm or hand
Pain or tenderness in the arm, shoulder, or neck
Redness or discoloration of the skin
Warmth to the touch
Visible enlarged veins near the surface of the skin
Heaviness or a "throbbing" sensation in the arm
Arm fatigue
Causes
The causes of UEDVT can include:
Central Venous Catheters (CVCs): This is the most common cause of UEDVT. CVCs are often used for administering medications, dialysis, or blood transfusions.
Thoracic Outlet Syndrome (TOS): Compression of the veins in the space between the collarbone and the first rib.
Repetitive arm movements: This can include activities such as weightlifting or sports.
Trauma: Injury to the arm or shoulder area.
Cancer: Certain cancers can increase the risk of blood clots.
Inherited clotting disorders (thrombophilia): Genetic conditions that make the blood more likely to clot.
Surgery: Especially surgeries involving the upper extremities or chest.
Dehydration: This can thicken blood and increase the risk of clots.
Oral contraceptives or hormone replacement therapy: These medications can increase the risk of blood clots.
Medicine Used
The primary medications used to treat UEDVT are anticoagulants (blood thinners), which prevent the clot from growing and reduce the risk of PE. These may include:
Heparin: Usually given intravenously or as an injection.
Low-molecular-weight heparin (LMWH): Given as an injection.
Warfarin: An oral anticoagulant.
Direct oral anticoagulants (DOACs): Such as rivaroxaban, apixaban, edoxaban, and dabigatran. In some cases, thrombolytic drugs (clot busters) may be used to dissolve the clot.
Is Communicable
No, UEDVT is not a communicable disease. It is not caused by an infectious agent and cannot be transmitted from person to person.
Precautions
Precautions to help prevent UEDVT include:
Minimize catheter use: If you have a CVC, ensure it's only used when medically necessary.
Stay hydrated: Drink plenty of fluids to prevent dehydration.
Regular movement: Avoid prolonged periods of immobility, especially after surgery or during long trips.
Manage underlying conditions: Effectively manage conditions like cancer or clotting disorders.
Evaluate medication risks: Discuss the risks of hormone therapy or oral contraceptives with your doctor.
If you have TOS: Consult with your doctor on the best management plan to reduce compression.
How long does an outbreak last?
UEDVT is not an outbreak, but rather a condition that develops in an individual. The duration of treatment for UEDVT varies but generally ranges from 3 to 6 months. The specific duration depends on the underlying cause of the clot, the individual's risk factors, and their response to treatment.
How is it diagnosed?
UEDVT is typically diagnosed using:
Ultrasound: A non-invasive imaging test that uses sound waves to visualize blood flow in the veins. This is the most common diagnostic test.
Venography: An X-ray of the veins after injecting a contrast dye.
MRI or CT scan: These imaging tests may be used in some cases to evaluate the veins in the chest and neck area.
D-dimer blood test: This blood test can help rule out the presence of a blood clot, but it is not specific for UEDVT.
Timeline of Symptoms
The onset of symptoms can vary, but they generally develop over a few days to weeks. The timeline might look like this:
Early Stages: Mild pain or tenderness in the arm, perhaps dismissed as muscle strain.
Progressive Symptoms: Swelling in the arm or hand gradually worsens over days. Redness, warmth, and visible enlarged veins may become apparent.
Later Stages: The pain intensifies, and the arm feels heavy or throbbing. Arm fatigue becomes more noticeable.
Note: In some cases, UEDVT may be asymptomatic and only discovered during testing for other conditions.
Important Considerations
Prompt diagnosis and treatment are crucial to prevent complications such as pulmonary embolism.
The underlying cause of the UEDVT needs to be identified and addressed to prevent recurrence.
Regular follow-up with a healthcare professional is important to monitor the effectiveness of treatment and manage any potential side effects.
Patients should be educated about the signs and symptoms of PE and instructed to seek immediate medical attention if they experience chest pain, shortness of breath, or coughing up blood.
Lifestyle modifications, such as staying active and hydrated, can help prevent future blood clots.