Keeping Blood Clots at Bay

Perhaps you’ve been advised to unbuckle your seat belt and move around the airplane during a long flight or to park your vehicle and take a walk to break up a long road trip. That’s good advice to keep your blood flowing and prevent a potentially deadly blood clot from forming in a deep vein, probably in one of your legs.

Such a clot — called a deep vein thrombosis (DVT) — could announce itself with swelling, pain or redness in the leg or other extremity where it occurs. But in about half of all cases, there may be no or very mild symptoms until the clot or thrombus breaks away, which is when the situation can get serious.

Movement is the best way to prevent this condition from occurring. But if that’s too late — you already have a throbbing leg that is warm to the touch, red or visibly swollen, call your general health care provider immediately.

Blood Clot Causes, Risk Factors

The ability of our blood to clot — in other words, to change from a liquid to a gel-like state — is essential to our survival. Without clotting, we could bleed out after the slightest injury. Instead, when an injury occurs, blood cells called platelets work with proteins in the plasma (the liquid part of blood) to stop the bleeding through a complex process called a coagulation cascade. That results in a stable clot over the injury. As the body heals, the clot naturally dissolves.

But sometimes, clots form without injury on the inside of blood vessels or fail to dissolve after healing. The major risk factors for developing these problem clots include:

• Age over 60
• A history of blood clots
• Post-surgery, especially those lasting 45 minutes or more and involving the hip, pelvis and leg fractures
• Prolonged immobility
• Cancer, especially if treated with chemotherapy
• Inherited or acquired conditions including Factor V Leiden, prothrombin mutation or antiphospholipid syndrome
• Pregnant or postpartum, especially with complications like preeclampsia or postpartum bleeding

Others who meet any of these criteria have a minor risk factor:

• Body Mass Index (BMI) above 30
• Hormone therapy, including birth control pills or hormone replacement therapy in menopause
• Smoking
• Other medical conditions like heart disease or systemic lupus erythematosus
• Recent surgeries, even minor, involving general anesthesia
• Acute illness involving bed rest
• Major trauma or leg injury
• Prolonged travel in a car, bus or plane

Knowing your risk factors will allow you to monitor your body for signs of a DVT and seek quick medical treatment should those signs appear.

Pulmonary Embolism

When a DVT breaks away from the site where it developed, it travels through the bloodstream, often until it reaches the lungs, where it can get caught and causes a blockage called a pulmonary embolism. This is a common but serious condition that causes 300,000 deaths a year in the United States, making it one of the leading causes of cardiovascular mortality.

Symptoms of a pulmonary embolism depend on the size of the clot, the extent of the blockage and your general health, but could include any of these:

• Sudden shortness of breath
• Chest pain, especially upon coughing or a deep breath
• Feeling lightheaded or dizzy
• Fainting
• Rapid pulse
• Rapid breathing
• Coughing up blood

Seek immediate medical care if you have these symptoms.

Treating Blood Clots

Your health care provider will use ultrasound to diagnose your deep vein thrombosis and its location. A CAT scan will be required to diagnose a pulmonary embolism.

It wasn’t long ago that either diagnosis meant up to a week in the hospital to administer and monitor your blood levels of drugs used to dissolve the clot and prevent new ones from forming. However, a new class of drugs called direct oral anti-coagulants (you may have heard them referred to as blood thinners) have made treatment so much easier that your health care provider could call in a prescription that you’ll start taking at home.

Your prescription blood thinner is designed to keep your blood clot from growing and preventing new clots from forming. However, it will not dissolve an existing clot. In most cases, your body will eventually take care of that job on its own.