What Are Blood Clots?
Do you travel? Or take birth control? Are you overweight? Have you ever injured your foot or leg? If you answered yes to any of these questions, the House Call Doctor’s episode on Deep Venous Thrombosis (DVT)–which has the potential to become life-threatening–is for you. Learn what blood clots are, who gets them, and how to tell if you have one.
Sanaz Majd, MD
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What Are Blood Clots?
This week, “American Idol” star, Michael Johns, sadly passed away at the young age of 35, due to a blood clot in his leg following an ankle injury. The news left many of us are wondering what a blood clot even is, and how it could become so serious. Who gets blood clots? And how would you even know if you have one?
It’s very important that we all recognize the potential symptoms of blood clots in the legs, because if caught early, it is very treatable and life-saving. Let’s find out some answers about blood clots in today’s episode.
What is a Deep Venous Thrombosis (DVT)?
What is a Deep Venous Thrombosis (DVT)?DVT’s are clots that abnormally form in the deep veins of the legs, often in the calf. They inhibit the passage of blood flow back to the heart, and as a result cause swelling and pain in the leg.
You may have heard about them, but who actually gets them? And, “so what?,” you may be thinking. Well, DVT’s are taken quite seriously, as they can have some potentially lethal complications. When a clot forms in the deep veins of the leg, they can break off and travel to the blood vessels in the lungs–this is referred to as a pulmonary embolus (PE). The typical patient with a PE may recall a leg swelling in the recent past, and experience shortness of breath. If not caught early, a PE can be potentially fatal.
This is not terribly common–but it’s not uncommon either, with estimates of about 900,000 cases of DVT’s and PE’s in the U.S. each year. Up to a third end up fatal, due to lack of treatment. But if caught early, it is often very treatable.
Symptoms of a DVT
How can you tell if you are experiencing a blood clot in the leg?
- They are typically in one leg only (verses both at the same time)
- Calf swelling (diameter can be measured in both calves to compare)
- Pain in the calf or thigh
- Redness in the calf
- Warmth in the calf
Risk Factors for DVT
There are some patients who are more prone towards getting blood clots, and these include those with:
- A recent hospitalization (hence, a period of immobility)
- Recent surgery on the hips/knees/legs/feet (again, where they were immobile)
- A recent leg injury
- Recent travel (again due to immobility)
- Hormonal contraceptive use, especially ones containing estrogen
- Use of other medications like hormone replacement therapy, tamoxifen, erythropoietin
- Family or personal history of a blood clot disorder (protein C or S deficiency, deficiencies of antithrombin, Factor V Leiden or prothrombin gene mutation)
- Pregnancy or postpartum
- Cancer
- Obesity
- Prior DVT or PE
Diagnosis of DVT
There are two common practices for ruling out a DVT:
- A two-step process: Ordering a blood test called a D-Dimer, that is often elevated in those with a blood clot. However, it has a high false-positive risk, so if it’s positive, it doesn’t necessarily mean there’s a clot. Therefore, if it’s positive, the second step is to obtain an ultrasound of the leg. If the D-Dimer is negative, it’s a good indication that there is no clot.
- Going straight to the ultrasound.
Treatment of DVT
Once an ultrasound shows a blood clot, patients are often placed on an anticoagulant (a medication to help thin out the blood) in order to dissolve the clot and prevent further formation of new ones. These drugs include possible injections or an oral medication (and often initially both.) Duration of treatment depends on the patient’s risk factors and whether or not they’ve had a clot before.
If you have any risk factors for DVT formation, please talk to your doctor about how to best reduce your risk.
