Complaints & connections · borters.ch
One leg thicker than the other — comparing sides says more here than any value, and the route to the lung is the reason for haste.
Also known as: DVT · deep vein thrombosis · phlebothrombosis
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A blood clot in a deep vein, almost always in the leg or pelvis. Blood backs up behind it, and from that comes the picture by which it is recognised: one leg thicker than the other, warm, tense, often bluish, with a dragging pain in the calf that increases on standing and on pulling the foot up. Comparing the two sides is decisive — two swollen legs are usually something else, one swollen leg is suspicious. It arises where three things meet: slow flow, an irritated vessel wall and blood that clots more readily. Hence the familiar list of occasions — an operation, a cast, bed rest, long journeys, pregnancy and the weeks after, hormonal contraception, smoking, cancer, inherited tendencies — and hence also the cases with no occasion at all. Two things make it dangerous. If the clot breaks loose it ends up in the lung. And if it stays too long the vein valves scar, which years later can lead to swelling, heaviness and open sores on the lower leg. Both are why a clot belongs recognised quickly and treated consistently — and both can be well averted.
At a young age, repeatedly, without a cause, in an unusual place or with thromboses in the family: then the question of a tendency is worthwhile. Important: do not measure during the event or under blood thinning.
If the inflammation sits in a superficial vein, a hard red cord can be felt and the leg stays slim. That is usually less serious — unless the cord reaches close to the groin or the back of the knee.
A one-sided swollen, painful leg belongs examined today and not the weekend after. An ultrasound of the leg veins settles it in minutes.
While the suspicion stands, the calf is left alone. Heat treatments and massage rollers also wait until it is clarified.
Once the blood thinning is running, movement is expressly wanted — the old idea of weeks in bed no longer holds and does more harm than good.
It eases the swelling and prevents the late damage to the skin. Fitted, not off the shelf, and put on in the morning before getting up.
After a clear, temporary cause usually three to six months; with no cause or with recurrence often longer. The question belongs asked and not left to chance.
The continuation of the same story — and the signs that allow no time to think.
Get up and walk, drink plenty, no tight waistbands, and with a previous clot discuss beforehand whether more is needed.
Get up every hour or at least circle the feet and tense the calves, drink plenty, no tight bands.
Anticoagulants stop the clot from growing and a new one from forming. The body dissolves it itself, over weeks to months. That is why treatment runs for at least three months, even when the leg has looked fine for a long time.
About one to two in a thousand people have a deep vein thrombosis each year; the risk rises markedly with age. The body breaks the clot down over weeks to months; some keep a swelling that improves over one to two years.
It is not total sitting time that counts, but how long in one stretch. Every half hour two to three minutes standing and a few steps — that restarts the calf pump.
Comparing sides matters most. Both legs swollen points rather to heart, kidneys or vein weakness.
The skin looks shiny and tight, the calf feels hard, and the surface veins stand out more.
A dragging calf pain that increases on walking and on pulling the foot up — often taken for muscle soreness that will not go.
An operation, a cast, flu spent in bed, a long flight or a long drive in the week before.
Sudden breathlessness, stabbing on breathing in or a racing heart mean a part has already reached the lung. Then it counts as an emergency.
Rarer, but it happens — usually in connection with a catheter, after unaccustomed overhead work, or with a narrow outlet at the shoulder.
Meant for ruling out, not for proving. With low suspicion and a normal value the matter is usually closed; it is raised after operations, in pregnancy, with inflammation and with age anyway.
Part of the baseline before blood thinning — especially the platelets, which are monitored under certain drugs.
Determines the choice and dose of the anticoagulant — the modern drugs are cleared by the kidneys.
Only relevant on warfarin: keep intake steady, avoid big swings. Not an issue on modern anticoagulants (DOACs).
Marketed as “natural blood thinning” — but they don’t replace medical anticoagulation in thrombosis. Interactions with existing therapy are also possible.
Oestrogen raises the readiness to clot. The risk therefore rises on the combined pill, in pregnancy and in the weeks after birth — after birth most of all. Amount and form have a say: patch and ring are no lower-risk than the tablet.
Progestogen-only preparations — mini-pill, hormonal coil, implant — do not raise the thrombosis risk appreciably as things stand. That is the most important practical difference for women who have already had one.
An overactive thyroid raises several clotting factors and von Willebrand factor. The link is described and rarely thought of — with a thrombosis and no obvious trigger TSH belongs on the list.
Immobility and dehydration promote clots — on long flights, stand up and move the calves.
After a clot mobilisation starts early — the old bed rest has been abandoned. Movement lowers the risk of post-thrombotic syndrome without raising the risk of embolism.
Caution with warfarin-type blood thinners: K2 preparations act at exactly that point and can shift the INR. With the newer medicines this does not matter.