Venous Thromboembolism (Blood Clots): 6 Key Pieces of Information You Need To Know

Venous Thromboembolism (Blood Clots): 6 Key Pieces of Information You Need To Know

Deep Vein Thrombosis (DVT) refers to the formation of a blood clot in one of the deep veins in the body. This usually occurs in the legs. The blood clot can lead to pain or swelling, but also can occur with absolutely no symptoms. Blood clots in the deep veins can break free and travel into the lungs which is known as a Pulmonary Embolism (PE). Venous Thromboembolism (VTE) is an umbrella term which includes both DVT and PE.

This is a condition which hits close to home for me. When I was a medical student, I worked with the VTE research group at Harvard Medical School. While I was researching VTE, my own mother suffered a life-threatening DVT/Pulmonary Embolus on a transatlantic flight to Ghana. She was in the intensive care unit at a small hospital in Ghana and fortunately, due to prompt diagnosis and excellent management, she survived. To this day, she remains on chronic anticoagulation (blood thinners).

Here are the six key pieces of information that you need to remember about this condition:

1. VTE is extremely common. According to the CDC, it’s estimated that as many as 900,000 people each year in the United States could be affected by DVT/PE. As many as 100,000 Americans may die of DVT/PE. About 1/3 of people with DVT/PE will have a recurrence within 10 years.
2. DVT can lead to the life-threatening complication known as Pulmonary Embolism. With Pulmonary Embolism, a blood clot travels from another part of the body to the lung. This can lead to shortness of breath, chest pain, coughing up blood, and other symptoms. It’s important to seek medical attention if any of these symptoms occur. Sadly, sudden death is the first symptom in 25% of people who have a PE.
3. There are many factors which are known to increase the risk for developing VTE. Some of these factors include advanced age, prolonged bed rest, surgery, pregnancy, oral contraceptives, obesity, smoking, cancer, and heart failure. There are all also heritable conditions which make blood clotting more likely. One of these is Factor V Leiden mutation.
4. There are some measures that can be taken to reduce the risk of DVT. Exercise is known to reduce the risk of blood clots. This is important for people who travel frequently. It’s important to avoid sitting still. On a long plane ride or a car trip it’s important to try to make time to stop frequently and walk around or at a minimum exercise your lower legs. Lifestyle changes such as weight loss and smoking cessation can also be beneficial. There is evidence that the use of compression stockings may also prove beneficial in reducing the risk of DVT and and edema (swelling) in airline travelers.
5. Several tests are available to diagnose VTE. A blood test called D Dimer can be used to rule out the presence of blood clots. An ultrasound of the legs is the most common test used to confirm a diagnosis of DVT. Imaging of the lungs by either CTA chest or VQ scan can be used to confirm a diagnosis of Pulmonary Embolism.
6. For patients who have been diagnosed with VTE, multiple treatment options exist. These include blood thinners, which can be given intravenously or orally. For more serious types of blood clots an IV infusion of a clotbusting medication called tPA can be given. For patients who are unable to receive blood thinners, a special filter can be placed in the the vena cava which is the large vein in the abdomen. This filter prevents clots from traveling into the lungs.

DVT can be a medical emergency, therefore if you have symptoms concerning for this condition it is important to seek urgent medical attention. Fortunately with prompt diagnosis and early initiation of treatment many patients will do well with medical therapy.