What you need to know about blood clots

Friday, September 07, 2012

GoLocalWorcester Health Team

Warning Signs of a Blood Clot

Often, you hear about a deep vein thrombosis (DVT) when a famous person has a clot in the leg that breaks free and enters into the lungs, causing a potentially fatal pulmonary embolism (PE). Tennis star Serena Williams suffered from a PE following a knee injury, which she has called, “the scariest moment in her life.” Luckily for Serena, the clot was caught and treated in time. But unfortunately, about one-third of all people who suffer a PE will die.

GoLocalWorcester interviewed Dr. Louis Messina, a vascular physician at UMass Memorial Medical Center, about the dangers of DVT and important information on how to prevent a clot.

What is a DVT/PE?

Deep vein thrombosis (DVT) occurs when a blood clot forms in a large vein. Typically, a DVT causes leg swelling and pain. Long term, about one-third of patients who experience a DVT will develop “chronic venous insufficiency”. Chronic venous insufficiency occurs as a consequence to damage to the delicate valves within veins caused by DVT. This condition can lead to chronic leg swelling, skin discoloration, and thickening.

Another major complication of acute DVT is pulmonary embolism whereby a portion or all of the blood clot breaks off and lodges in the veins of the lung that prevents oxygen from entering the blood stream.

Are you at risk for a blood clot?

According to Centers for Disease Control and Prevention, anywhere between 300,000 to 600,000 Americans are affected DVT/PE each year and 60,000 to 100,000 people die as a result. Many of those who have a DVT/PE also have complications that can greatly impact their quality of life.

Blood clots can happen to anyone, not only the elderly population. While certain conditions, such as pregnancy, immobilization due to injury or surgery, and cancer, can increase the risk of clots, most clots are a result of something else entirely. When you don’t use your calf muscles for long periods of time, such as on long trips in the car or plane, the movement of blood is more sluggish. Slow-moving blood is more likely to clot. In addition to being sedentary, dehydration, trauma during surgery, or a car crash injury can increase the risk. About 15% of people who develop DVT do so in part due to a genetic predisposition. The most common such mutation is called the Factor V Leiden mutation.

What are blood clot symptoms?

DVT symptoms and signs aren’t always obvious. The classic signs, however, include a swollen and tender calf or leg. Unfortunately, these classic signs are present less than 50 percent of the time in DVT.

Other possible symptoms include:

Red areas on the leg
Swelling in one area or on one leg
Pain or tenderness in one leg
Temperature differences between the two legs (a leg with a clot may be warmer to the touch)

How are clots treated?

Treatment for blood clots usually involves anti-coagulants that keep the clot from worsening until the body has a chance to dissolve it. A filter is another option for people who have a history of bleeding in the stomach, bowel, or brain and are not able to safely take the blood thinners that are a standard of care for dangerous blood clots. For this procedure, physicians insert a spider shaped filter to catch the clots if they break loose. It’s placed inside the big vein in the abdomen that returns blood to the heart, called the inferior vena cava. The procedure for inserting and removing clots is relatively simple and can often be performed without general anesthesia.

Tips for avoiding a clot

One primary way to avoid DVT is to avoid prolonged periods of sitting or standing. For example, the next time you take a long flight or are in a situation where you sit for long periods of time, contract your calf muscles periodically or get up and walk for short periods. Here are some additional tips for preventing a clot:

Pump your calf muscles by pushing your heels into the floor and then lifting up on your toes
If you have room, stretch your legs straight out in front of you and flex and rotate your ankles
Ask your doctor about the appropriate compression socks
Make sure to stay well hydrated
If at all possible, get up and walk around every half hour

You can find more information about DVT/PE on the UMass Memorial Medical Center website.