Blood clots are not uncommon after surgery, especially major surgery on the pelvis, knees or hip. Blood clots, known as deep vein thrombosis (DVT), form most often in the lower leg or thigh, the Merck Manual states, but can also develop in the upper extremities. Immobility after surgery leads to a decrease in blood return from the veins to the heart, since activity normally helps move blood back to the heart. Blood pools in the legs, facilitating development of blood clots. In 50 percent of cases, DVT has no symptoms, Massachusetts General Hospital (MGH) states.
Pain and Tenderness
In many cases, DVT causes pain in the affected extremity. Pain may be more intense when standing or walking if the DVT is in the leg. Touching the extremity may cause discomfort. Sometimes the discomfort is mild in lower extremity DVTs, more like a dull ache, which may be felt only when walking, MGH explains.
DVTs can cause noticeable visual changes in the extremity. These include redness, warmth, swelling and discoloration in the area of the DVT. The vein may appear ropy and lumpy, and the veins around the affected vein may appear dilated and more visible than usual. When the skin over the affected area is pressed, a small dimple, known as pitting edema, may remain. The Merck Manual states that a difference of 3cm in circumference between the affected and non-affected leg due to swelling is most likely to indicate a DVT.
The most serious symptom of DVT occurs when a large clot breaks away from the extremity and travels to the lungs. A pulmonary embolism, or PE, occurs when a clot lodges in the arteries of the lungs, causing decreased blood flow. Around 50 percent of people with DVTs have occult, or asymptomatic PEs, Merck reports; large PEs can be life-threatening if they block the flow of blood from the right side of the heart to the lungs. Symptoms include sudden shortness of breath, wheezing, coughing, chest pain, rapid, weak or irregular heartbeat, light-headedness or fainting and low blood pressure. Baylor College of Medicine reports that 4 out of 100 people who develop DVT die from PE complications.
A DVT can permanently damage the veins in a leg or an arm. Long-term damage can cause permanent swelling of the extremity and skin breakdown over the damaged area. Discoloration, scaling and itching can occur, and the extremity may be painful during use.