Deep Vein Thrombosis

A few years ago, one of our country’s well known musicians died suddenly at a rather young age just after she was said to have returned from a trip. For many people it was the first time they had heard of a condition where blood clots had led to death. Several conditions increase the risk of blood clot formation, especially in women, thankfully however they do not always lead to death.

Deep vein thrombosis (DVT) is a condition that occurs when a blood clot forms in a vein deep inside a part of the body. It mainly affects the large veins in the lower leg and thigh, but can occur in other deep veins such as in the arms and pelvis. Deep vein thrombosis is a serious condition because blood clots in your veins can break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism) and eventually leading to death.

Causes

Blood is meant to flow. If it becomes stagnant, there is a potential for it to clot. The blood in veins constantly forms microscopic clots that are routinely broken down by the body. If for any reason the balance of clot formation and resolution is disrupted, significant clotting can occur. A blood clot can form if one or a combination of the following situations is present.

Immobility- any condition that causes you to stay in one place without moving for long periods of time.
Prolonged travel and sitting, such as long airplane flights (“economy class syndrome”), car, or train travel
Hospitalization
Surgery

 
Who’s at risk of DVT?
Certain people are more at risk of DVT than others. Conditions that may increase your risk of DVT include

flights of eight hours or more:

• history of DVT or pulmonary embolism
• cancer
• stroke
• heart disease
• inherited tendency to clot (thrombophilia)
• recent surgery –  especially in the pelvic region or legs
• obesity
• pregnancy
• hormone replacement therapy

The combined contraceptive pill and hormone replacement therapy (HRT) both contain the female hormone oestrogen, which causes the blood to clot more easily. If you’re taking either of these, your risk of developing DVT is slightly increased.

Symptoms

Deep vein thrombosis may sometimes occur without any noticeable symptoms.

DVT mainly affects the large veins in the lower leg and thigh, most often on 1 side of the body. The clot can block blood flow and cause:

• Changes in skin color (redness)
• Leg pain. The pain often starts in the calf and can feel like cramping or a soreness.
• Leg swelling (edema) Swelling in the affected leg. Rarely, there may be swelling in both legs.
  Skin that feels warm to the touch

Prevention
To prevent deep vein thrombosis:

• Moving your legs often during car trips, and other situations in which you are sitting or lying down for long periods.
• On long plane trips it is always a good idea to get up and walk around from time to time. Also flight socks can be worn. Stay hydrated by drinking lots of water.
• DO NOT smoke. Smoking causes the blood to flow more slowly through the veins. Talk to your doctor if you need help quitting.

For people who have inherited blood clotting disorders, they may need to be placed on anticoagulant medication which causes their blood to be thinner/less viscous. These medications have their own side effects which can be unpleasant and even fatal and should be taken carefully and supervised closely by a doctor. With blood tests done regularly to check that the blood has not become too thin as this can be dangerous as well.

Complications

• DVT often goes away without a problem, but the condition can return. Some people may have long-term pain and swelling in the leg called post-phlebitic syndrome.
• The risk of VTE recurrence appears greater if the initial event was unprovoked, or associated with persistent risk factors such as cancer rather than a transient risk factor like surgery.
• The most life-threatening complication of deep vein thrombosis is Pulmonary embolism. This happens when a blood clot that has been formed (usually in the legs) breaks off and travels up to the lungs to cause blockage of a blood vessel.
• If you develop signs or symptoms of a pulmonary embolism seek medical attention immediately.

The warning signs of a pulmonary embolism include:

• Unexplained sudden onset of shortness of breath
• Chest pain or discomfort that worsens when you take a deep breath or when you cough
• Feeling lightheaded or dizzy, or fainting
• Rapid pulse
• Coughing up blood

From time to time we hear stories of pregnant women who appear in perfect health even up until the time of delivery and then suddenly die under somewhat mysterious circumstances. Many times in such cases pulmonary embolism is the cause of death. This is because pregnancy is already a risk factor for DVT and then coupled with the tiredness of carrying another human inside them many pregnant women tend to not move around so much. In some cases when the pregnancy is considered high risk some women are even placed on mandatory bed rest.

So the next time you’re going to visit that pregnant friend or relative, buy her a pair of thromboembolic stockings. You might just be saving her life.