Blood clots, many people believe, happen to the very inactive or the elderly. But the facts about blood clots may surprise you. The American Heart Association reports that blood clots occur in approximately 2 million Americans every year. According to Dr. Victor Tapson, of Duke University Medical Center, a complication of blood clots called pulmonary emboli (blood clots that break free from the wall of a vein and travel to the lung) kill more Americans annually than AIDS, breast cancer and highway fatalities combined. Despite this staggering fact, this problem is little emphasized to the public. So let’s explain what blood clots are, how they occur, how they are diagnosed and what you can do to reduce your risks.
A blood clot (technically called a deep vein thrombosis or DVT) occurs when blood inappropriately forms a clot. This usually happens in the wall of one of the deep veins of the legs and causes partial or complete blockage of blood flow back to the heart from that area. The clotting process is a normal and necessary activity when you get a cut or have an injury, since it prevents undue blood loss.
However, when various factors combine to provide an unhealthy situation, clots can form at the wrong time and place. For example, the chance of developing a DVT may increase after surgery, especially after hip or knee surgery, or after infections or traumatic injuries. Various medical conditions including some types of cancer and Crohn’s disease also increase your risks. According to Thrombosis Online, a resource center educating the public about DVT’s, pregnant women are 5 times more likely to develop DVT’s than other women. Birth control pills or estrogen replacement may also increase the risk, especially with other risk factors such as smoking, high blood pressure or obesity.
Recently some attention has been given to a medical condition called “Economy Class Syndrome.” This is because anyone sitting for a long time in cramped quarters increases the risk of developing DVTs. Although the popular name for this condition was coined for the cramped legroom of flying economy class, the syndrome applies during long rides in an automobile.
Another difficulty with DVTs is that 50% of cases are symptom free. Symptoms usually include pain, tenderness, swelling, warmth and discoloration around the site of the clot. As a physical therapist, I have seen a DVT mimic calf strain pain. When there is uncertainty as to the origin of such pain, it is always best to have a possible DVT ruled out by a physician.
Symptoms of pulmonary emboli (PE), a complication of a DVT referred to earlier, include shortness of breath, sharp chest pain, bloody sputum, rapid pulse, a feeling of apprehension and fainting. This complication can be life threatening if the clot blocks a main pulmonary artery (artery in the lung). Anyone with these symptoms must go immediately to a hospital emergency room.
Several tests, including Doppler Ultrasound, venography and MRI, effectively diagnose the presence of a DVT. Each test has its advantages, depending on the suspected location of the clot. The easiest and most common test is ultrasound.
Although heredity does play a role in DVTs you can lessen your risks with these simple precautions when you travel. Dress comfortably and avoid anything tight around your calves or legs. Keep hydrated by drinking lots of non-caffeinated and non-alcoholic liquids. Move your knees, ankles and toes up and down vigorously from time to time. Take every opportunity to get up and stretch your legs. Take slow deep breaths once in a while. Wearing prescription support hose may also help if you have a history of DVTs.
If you have been diagnosed with a DVT, your doctor will usually prescribe medication taken by injection or intravenously. Other practical measures include elevating the affected leg, applying heat, wearing support hose and avoiding immobility. Once diagnosed, the treatment for this condition is very effective.