Risks of Deep Vein Thrombosis - Interview with Judith Brannan Sigvaris

LegSmart.com interviewed the Educational Manager of Sigvaris, Judith Brannan about the risks of DVT.

What is a DVT?

Deep Vein Thrombosis (DVT) is a blood clot that usually forms in the deep veins of the lower leg or calf which can block the flow of blood. Generally a DVT is caused by a combination of two or more underlying conditions including (1) slow or sluggish blood flow through a major vein; (2) a tendency for a person’s blood to clot quickly, (sometimes inherited) and (3) irritation or inflammation of the lining surface of the vein.

What increases your risk of a DVT?

Some of the risk factors include:

  • Prolonged sitting or restricted mobility, such as long-distance travel
  • Prolonged bed rest or immobility
  • Surgery (especially orthopedic) or major injury which results in being in a cas
  • Excessive weight
  • Sedentary lifestyle
  • Smoking
  • Age over 40
  • Rcent development of Varicose Veins
  • High Estrogen states, such as pregnancy or when using birth control pills
  • Certain cancers
  • Some blood factors such as Factor V Leiden

What are the warning signs of a DVT?

A DVT may cause leg pain, tenderness, swelling, warmth and/or redness – but can also be present with no symptoms.

What are the complications of a DVT?

There are two. About one-third of patients with DVT, develop a long-term complication known as Post-Thrombotic Syndrome (PTS). This condition can show up as chronic pain, swelling, discoloration of the leg, as well as the development of an open ulcer. The likelihood of another clot forming is high once you have had an initial DVT.

Another complication is known as a Pulmonary Embolism (PE) which is when the clot breaks loose and travels through the vessel to the arteries located in the lungs. A PE is a potentially fatal condition if it significantly blocks blood flow through the lungs.

Approximately 2 million patients suffer from a DVT and approximately 600,000 will be hospitalized each year. Some people have a DVT, but it is asymptomatic. Unfortunately, 200-300,000 people die each year due to this complication.

Are DVT’s common among young people?

Surprisingly so! Many people think of blood clots as a problem occurring in elderly people, but not in young and apparently healthy individuals. A DVT can happen to anyone regardless of age.

A pregnant woman, for example, is 5-6 times more likely to develop a DVT than a non-pregnant woman. This risk is enhanced due to changes in hormones and an increase in blood volume. Unfortunately, 50% of post-delivery maternal deaths are caused by Pulmonary Embolisms (PE).

Another high risk environment for younger people involves athletes. Athletes are at a greater risk for the development of a clot due to dehydration and a possible lower resting heart rate which results in slower blood flow throughout the body. Did you know that 85% of air travel thrombosis victims are athletic, usually endurance athletes? [1]

Of all air traveler, 3-5% of them will develop blood clots. Within the age group 20-44, air travel thrombosis is the number one cause of death. Doesn’t that surprise you?

And, recently an “extreme gamer” died of a pulmonary embolism after playing video games for up to 12 hours a day. He was 20 years old! [2]

What can be done to reduce the risk of a DVT?

In most cases, Deep Vein Thrombosis is a preventable disease. People undergoing surgery and in the hospital for an extended period of time may be at risk for developing blood clots. Your health care provider will guide you on the best ways to minimize your risk of developing DVT in these situations.

If you are not hospitalized, you can still develop blood clots. Smoking cessation, weight loss and exercise can decrease your risk of developing a blood clot. When you travel for a long period of time (over 4 hours) you are at an increased risk which can be minimized by getting up and walking or doing foot flexes every 30 minutes. Wearing a low level (15-20 or 20-30 mmHg) of graduated compression will also decrease your risk of developing a clot and certainly eliminate the swelling associated with long distance travel.

Once I have a DVT what can I do about it?

There are several common treatment options considered once DVT is diagnosed. In general, blood clots in larger veins, especially behind the knee, in the thigh and pelvis are normally treated with drugs commonly referred to as blood thinners (usually an injectable low molecular weight heparin which is injected below the surface of the skin of the abdominal wall), whereas smaller clots close to the ankles might not have blood thinners prescribed. Some patients may need a small temporary filter placed into the Vena Cava. The best regimen for the patient will be decided by his/her healthcare professional. Always speak with your doctor if you have questions concerning your health!

Additionally, since the lack of mobility is a contributing factor to clot formation, most patients are encouraged to be active rather than being advised to keep still or initiate bed rest. Compression therapy is an important part of treatment as well for relief of swelling, and as part of the treatment to prevent the above described complication known as Post-Thrombotic Syndrome (PTS). PTS varies from mild swelling to incapacitating swelling with pain and ulceration. Up to 60% of patients with a history of DVT develop PTS, and about 10% of these people will have skin break down in the lower part of the leg, called a venous stasis ulcer.

What can we do to raise DVT awareness?

Although the diagnosis of DVT is serious, by recognizing the symptoms and seeking immediate medical attention, Deep Vein Thrombosis can be treated and wearing graduated compression stockings will minimize the symptoms and complications. As long as people are aware of the risks associated with DVT, we can spread the word about proper prevention and treatment options. Knowledge is power and knowing the education behind DVT can prevent a lot of unnecessary deaths.

Links:

1. Air Health.org – Danger! Athletes. May 5, 2006. (top)

2. BBC – Gamer’s death blamed on DVT. July 30, 2011. (top)


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