The Dangers of Deep Vein Thrombosis

Group wants to boost awareness of potentially deadly blood clots

SATURDAY, April 6, 2002 (HealthDayNews) -- It's a silent menace that kills 200,000 Americans each year -- more than AIDS, breast cancer and highway accidents combined.

Yet few Americans know about the life-threatening nature of deep vein thrombosis (DVT), which occurs when a blood clot forms in one of the large veins in the arms, legs or pelvis.

Every year, 2 million Americans -- many of whom feel fit and show no signs of circulatory problems -- develop DVT. The blood clot itself may not be dangerous. But if left untreated, it can travel to the lungs and cause a fatal pulmonary embolism.

The American College of Chest Physicians says fatal pulmonary embolism may be the most preventable cause of deaths in hospitals, where clots are common among patients recovering from surgery.

To heighten public understanding of DVT, a group of experts on the condition have formed the Council for Leadership on Thrombosis (CLOT) Awareness and Management. The 11-member national panel plans to raise awareness of the dangers posed by blood clots by promoting prevention and treatment programs.

DVT is a serious public health problem that demands more attention from the public and the medical community, says Dr. Samuel Z. Goldhaber, a co-chairman of the council. He's also medical director of the anticoagulation service at Brigham and Women's Hospital in Boston, and an associate professor of medicine at Harvard Medical School.

Heart attack, stroke and cancer have all overshadowed it, but "DVT is one of the major medical issues. And I think focus needs to be shifted, so we can do everything possible for prevention and early detection and treatment," Goldhaber says.

This is the first attempt to push the message that DVT is a critical public health issue, says CLOT co-chairman Dr. Victor F. Tapson, associate professor at Duke University's Division of Pulmonary Medicine.

Among the CLOT initiatives is a DVT screening program of 7,500 people at more than 200 hospitals across the country. It will collect information about people with DVT and their treatment in order to establish a nationwide database to define care standards for people with blood clots.

Also available is a ClotAlert Resource Center, which hopes to educate the public and health professionals about the risk factors and symptoms of DVT.

Blood clots can form when blood circulating to a part of the body becomes abnormally sluggish or when blood vessels have been damaged.

If the clot breaks free and travels through the veins, it can reach the lungs and lodge there, causing a pulmonary embolism. The embolism obstructs the pulmonary artery or its branches, which supply blood to the lungs, and causes lung tissue damage, disrupts lung functioning and can lead to death.

DVT commonly occurs in one leg, usually the calf. Symptoms may include tenderness, pain, swelling and discoloration or redness. But in about half the cases, there are no symptoms.

"The most common initial symptom of a blood clot is a cramping in the calf that doesn't go away," Goldhaber says.

Don't disregard that warning, Tapson adds.

"If someone does say they have a pain in their calf or thigh, particularly with swelling, it can't be ignored. It's got to be explored. It can't be written off as a charley horse, as a pulled muscle or something like that unless there's pretty good evidence that that's what it is," Tapson says.

Shortness of breath or chest pain, especially when you take a deep breath, are other warning signs. It could mean that a blood clot has already entered your lungs.

"Even when it's not life-threatening, the leg swelling that can develop [with DVT] can lead to a decrease in the quality of life," Goldhaber says.

There are certain individuals at particular risk for DVT. They include people who are paralyzed or immobile because of injury or illness, the elderly, someone with a family history of the condition, the obese, women who have undergone estrogen therapy, cancer patients and those undergoing chemotherapy, and people who've had recent surgery or suffered a trauma injury.

Sitting for long periods of time on an airliner may increase your chances of DVT.

And hip fractures can be especially dangerous.

"It's a very high-risk scenario. Just by virtue of the fact the person has a hip fracture, the physician ought to be on watch, or guard, for a blood clot problem," Tapson says.

Pregnancy is another time when DVT can strike.

"It's one of the more common reasons a young woman might develop pulmonary embolism," Tapson says.

The good news is that when DVT is diagnosed, it's easily treated, Tapson adds.

That includes bed rest, elevation of the affected limb, and use of compression stockings and blood-thinning drugs to break up the clot. The blood-thinning drugs can also be used as a preventive measure for people prone to DVT.

What To Do

For more information about DVT and pulmonary embolism, you can call the ClotAlert Resource Center at 1-800-CLOT-FREE.

You can learn more about DVT from the American Academy of Orthopaedic Surgeons, or the Boston University Medical Center.

And the National Institutes of Health offers this overview of pulmonary embolism.

SOURCES: Interviews with Samuel Z. Goldhaber, M.D., director, Venous Thromboembolism Research Group, and medical director, Anticoagulation Service, both at Brigham and Women's Hospital, and associate professor of medicine, Harvard Medical School, Boston; Victor F. Tapson, M.D., associate professor, Division of Pulmonary Medicine, Duke University, Durham, N.C.
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