Introduction
Deep Vein Thrombosis or DVT is a vascular disease that may cause severe complications if left untreated. It is manifested when a blood clot is left loose in a deep vein. Due to various reasons, a blood clot or thrombus may form and enter a deep vein. It is mostly seen in bigger veins in the lower limbs but the clot can travel through the blood vessels and end up in organs like lungs, leading to life-threatening complications.
Signs and symptoms of Deep Vein Thrombosis (DVT)
- Cramps or throbbing type of pain in one leg. It is felt mostly in thigh or calf area.
- Oedema in the leg
- Sore feeling in the affected area
- Skin feeling warm around the area affected
- Reddish or dark discolouration of the area
- Veins swollen or hard to touch
Causes of Deep Vein Thrombosis
Defective circulation roots the main cause for Deep Vein Thrombosis. In that way, any condition that hampers the blood flow can cause DVT. Often a damaged vein following a surgery or an inflammation leads to DVT. Damage to veins can be due to injury or infection also.
Other risk factors include:
Previous history of DVT
A positive family history of DVT
Old age
Obesity
A central vein with a catheter placed
Familial or genetic clotting diseases of blood
Pathophysiology of deep Vein Thrombosis
Thrombus means a blood clot. When such a blood clot is formed in one or many veins that are situated deep inside the body, the disease called DVT develops. DVT is mostly seen in the legs, and it begins with venous valve cusps. The thrombus or the blood clot is mostly made up of thrombin, fibrin, Red Blood Corpuscles and very few platelets.
Diagnosis of Deep Vein Thrombosis
History taking including family history
Physical examination
Duplex ultrasonography being an imaging test using sound waves to analyse the blood flow
Venography with X rays and a dye to detect the veins
Though there is no exact blood test to diagnose DVT, D-dimer test analyses a protein fragment, d-dimer, released in the blood during the breakage of the clot in blood
In some cases, MRI is needed to detect DVT especially in areas like abdomen
Treatments for Deep Vein Thrombosis
Medicines like anti-coagulants that thins the blood
Medicines like thrombolytics that break the clots inside the body
Compression stockings that preventing the collection of blood in the legs. They help prevent swelling in the lower extremities when used properly.
Surgical insertion of filters into a big vein like inferior venacava in the abdomen to filter any probable clot entering the circulation leading to lungs and other vital organs in the upper body
Prognosis of Deep Vein Thrombosis
Most cases of DVT can be reversed when diagnosed early with a small clot. But the condition tends to recur often. Patients with bigger clots and those who are diagnosed late are difficult to treat and may end up with serios complications
Complications of Deep Vein Thrombosis
Pulmonary embolism
Post-phlebitis syndrome
Chronic Venous insufficiency
DVT and Ayurveda
There is no directly named correlation for deep vein thrombosis in Ayurveda. But clinically most cases can be compared with Vaatarakta considering both the poorvaroopa & lakshana.
Nidana-Ayurvedic causes
Food which is Vidaahi, viruddham & asrkpradooshanam (causing indigestion&acidity, opposite in potency, causing vitiation of Rakta)
Unhealthy habits of sleep & waking up, sex
Intolerant personality
Sedentary lifestyle
Injury
Absence of Sodhanakriya (panchakarma)
Causative factors for the vitiation of rakta along with usage of Vaata-vitiating and cold diet & regimen can lead to circulatory damage and result in DVT
Poorvarupa- Ayurvedic premonitory signs and symptoms
Similar to Kushtha (skin manifestations like rashes with itching etc.)
Samprapti-Ayurvedic pathogenesis
Due to its causative factors, Rakta gets vitiated in the body. This person when uses Vaata-vitiating and cold diet & regimen Vaata also gets vitiated & travels through abnormal path in the body. When this Vaata gets obstructed by the aggravated Rakta, Vaata vitiates that rakta also and produces the disease called Vaatarakta.
Lakshana – Ayurvedic signs and symptoms
Saada – fatigue
Slathangatha – feeling of loose joints & body
Kandu (itching)
Sphurana (throbbing)
Nisthoda (pricking pain)
bheda (piercing pain)
gaurava(heaviness)
suptata(numbness) of joints especially in the lower limbs
Sadhyasadhyata-Ayurvedic prognosis
Yaapya-manageable
Chikitsa-Ayurvedic treatment
Ayurvedic treatment for Vaatarakta starts with balancing the vitiated Rakta by doing raktamoksha (blood letting) which is done after using Sneha therapy prior to it. Raktamoksha should be done intermittently, considering the strength of the patient & balancing Vaatadosha.
Samana
Lepanam & parishekam with soolahara & raktaprasadana dravyas
Swedanam
Upanaham
Aamapachanam
Agnideepanam
Puraanaghrutam in Vaata dominant Vaatarakta
Sodhana
Raktamoksha
Virechanam
Vasti -especially ksheeravasti
Commonly used Ayurvedic medicines
Drakshadi kashayam
Patolaksdurohinyadi kashayam
Guduchi sattwam
Kokilakshakam kashayam
Guduchyadi kashayam
Ksheera Guluchi
Sahacharadi Tailam
Home remedies
Certain home remedies and lifestyle modifications will help to improve the quality of life while living with Vaatarakta. This includes exercise, rest, and assistive devices.
Exercise – Low impact exercises can help to improve the range of motion in the joints and increase their mobility. Exercise can also strengthen muscles, which can help to relieve some of the pressure from joints.
Get enough rest and sleep
Apply heat or cold accordingly
Ice packs or cold compresses can help to reduce inflammation and pain. They may also be effective against muscle spasms.
Massage from down to up direction that help the venous circulation towards the heart
Try assistive devices such as splints and braces can hold the joints in a resting position. This may help to reduce inflammation.
Canes and crutches can be helpful to maintain mobility, even during flares.
Diet and behaviour suitable
To be avoided :
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbed digestion and reduces the bioavailability of the medicine
Carbonated drinks – make the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
To be added:
Light meals and easily digestible foods
Green gram, soups, fresh vegetables, fruits and leaves.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Lack of body movement is one of the main cause of Vaatarakta
Yoga and Pranayama
Yoga and exercises are not advised in very severe and acute stages.
Nadisuddhi pranayama helps in imprvig the oxygen saturation.
Yagasanas that improve circulation towards the lower limb include:
Salabhasana
Naukasana
Dhanurasana
Pavanamuktasana
Research papers
https://ijapr.in/index.php/ijapr/article/view/2073
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