What causes blood clots in legs. How does obesity contribute to DVT risk. Why does smoking increase chances of blood clots. Can surgery lead to deep vein thrombosis. How do inflammatory bowel diseases affect blood clotting.

Understanding Deep Vein Thrombosis (DVT) and Its Risk Factors

Deep vein thrombosis (DVT) is a serious condition characterized by the formation of blood clots in deep veins, typically in the legs. These clots can pose significant health risks, including the potential for pulmonary embolism if they break loose and travel to the lungs. Understanding the risk factors associated with DVT is crucial for prevention and early intervention.

What is Deep Vein Thrombosis?

DVT occurs when a blood clot forms in one of the deep veins of the body, most commonly in the legs. This condition can lead to serious complications if left untreated. The clot can partially or completely block blood flow through the vein, causing swelling, pain, and other symptoms.

Prolonged Inactivity and Its Impact on Blood Clot Formation

One of the primary risk factors for developing DVT is prolonged inactivity, particularly during long-distance travel or extended periods of bed rest. When the body remains stationary for extended periods, blood flow in the legs can slow down, increasing the likelihood of clot formation.

How does prolonged sitting affect blood circulation?

During extended periods of sitting, the muscles in the legs are not actively contracting, which normally helps to pump blood back to the heart. This reduced muscle activity can lead to blood pooling in the veins of the lower extremities, creating conditions favorable for clot formation.

• Long-distance flights or car trips
• Extended bed rest due to illness or surgery
• Sedentary lifestyles with prolonged periods of sitting

To mitigate this risk, it’s recommended to move around frequently during long trips or periods of inactivity. Simple exercises like ankle rotations, calf raises, and walking up and down the aisle of an airplane can help maintain blood flow and reduce the risk of clot formation.

The Link Between Obesity and Deep Vein Thrombosis

Excess weight, particularly obesity, is another significant risk factor for developing DVT. The additional pressure on the lower body caused by excess weight can impair blood circulation in the legs, increasing the likelihood of clot formation.

How does obesity contribute to DVT risk?

Obesity can affect blood circulation in several ways:

1. Increased pressure on veins in the legs
2. Reduced mobility and physical activity
3. Chronic inflammation associated with obesity
4. Potential hormonal imbalances affecting blood clotting

While being overweight or obese doesn’t guarantee the development of DVT, it does increase the risk, especially when combined with other risk factors. Maintaining a healthy weight through proper diet and regular exercise can help reduce this risk.

The Impact of Smoking on Blood Clot Formation

Smoking is a well-known risk factor for various health issues, including DVT. The harmful effects of smoking extend to the circulatory system, increasing the likelihood of blood clot formation.

Why does smoking increase the chances of blood clots?

Smoking affects blood clotting in multiple ways:

• Damages the lining of blood vessels
• Increases platelet stickiness, making them more likely to clump together
• Alters blood chemistry, promoting clot formation
• Reduces overall blood flow and oxygen levels

Quitting smoking is one of the most effective ways to reduce the risk of DVT and improve overall health. While challenging, various strategies and support systems are available to help individuals quit smoking successfully.

Age as a Risk Factor for Deep Vein Thrombosis

As individuals age, their risk of developing DVT increases. While the exact reasons for this are not fully understood, several factors contribute to this increased risk in older adults.

Why are older adults more susceptible to DVT?

Several age-related factors contribute to the increased risk of DVT in older adults:

1. Decreased mobility and physical activity
2. Higher likelihood of developing other health conditions that increase DVT risk
3. Changes in blood composition and clotting factors
4. Weakening of blood vessel walls

While age is an uncontrollable risk factor, older adults can take steps to mitigate their risk by staying active, maintaining a healthy weight, and managing other health conditions that may contribute to DVT risk.

Surgery and Injury: Elevated Risk for Blood Clot Formation

Undergoing surgery or experiencing a significant injury can substantially increase the risk of developing DVT. The combination of tissue damage, reduced mobility, and changes in blood flow during and after these events creates an environment conducive to clot formation.

How do surgical procedures contribute to DVT risk?

Surgery can increase DVT risk through several mechanisms:

• Direct damage to blood vessels during the procedure
• Prolonged immobility during recovery
• Release of tissue factors that promote blood clotting
• Use of certain medications that may affect blood clotting

To mitigate this risk, healthcare providers often implement preventive measures such as early mobilization, compression stockings, and anticoagulant medications for high-risk patients.

Genetic Factors and Blood Clotting Disorders

Certain genetic factors and inherited blood clotting disorders can significantly increase an individual’s risk of developing DVT. These conditions can affect the body’s ability to regulate blood clotting, leading to an increased likelihood of excessive clot formation.

What are some common inherited clotting disorders?

Several genetic conditions can increase the risk of DVT:

1. Factor V Leiden mutation
2. Prothrombin gene mutation
3. Protein C or Protein S deficiency
4. Antithrombin deficiency

Individuals with a family history of DVT or known clotting disorders should discuss their risk with a healthcare provider. Genetic testing may be recommended in some cases to identify specific clotting disorders and guide preventive strategies.

The Connection Between Inflammatory Bowel Disease and Blood Clots

Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, have been associated with an increased risk of DVT. While the exact mechanisms are not fully understood, the chronic inflammation and alterations in the immune system characteristic of these conditions may contribute to abnormal blood clotting.

How do inflammatory bowel diseases affect blood clotting?

Several factors may contribute to the increased DVT risk in IBD patients:

• Chronic inflammation affecting blood vessel function
• Alterations in the immune system that impact clotting processes
• Potential genetic factors common to both IBD and clotting disorders
• Reduced mobility during disease flares

Patients with IBD should be aware of this increased risk and discuss preventive measures with their healthcare providers, especially during active disease periods or hospitalizations.

Cancer and Its Impact on Blood Clot Formation

Cancer and its treatments can significantly increase the risk of developing DVT. The complex interactions between cancer cells, the immune system, and blood clotting mechanisms contribute to this elevated risk.

Why does cancer increase the likelihood of blood clots?

Several factors contribute to the increased DVT risk in cancer patients:

1. Release of pro-coagulant substances by cancer cells
2. Damage to blood vessels by tumors or cancer treatments
3. Reduced mobility due to illness or treatment side effects
4. Use of certain chemotherapy drugs that may affect clotting

Cancer patients and their healthcare providers should be vigilant about the risk of DVT and implement appropriate preventive measures, which may include anticoagulant medications in some cases.

Understanding these risk factors for deep vein thrombosis is crucial for prevention and early intervention. While some risk factors, such as age and genetic predisposition, are beyond our control, many can be mitigated through lifestyle changes and preventive measures. Regular physical activity, maintaining a healthy weight, avoiding smoking, and being aware of the signs and symptoms of DVT are all important steps in reducing the risk of this potentially serious condition.

For individuals with multiple risk factors or concerns about their DVT risk, consulting with a healthcare provider is essential. They can provide personalized advice, recommend appropriate preventive strategies, and conduct necessary screenings or tests to assess individual risk more accurately.

By staying informed and proactive about DVT risk factors, individuals can take significant steps towards protecting their vascular health and overall well-being. Remember, early recognition and prompt treatment of DVT can prevent serious complications and ensure better outcomes for those affected by this condition.

What Causes Blood Clots? 11 Things That Can Raise Your Risk

If you know you have other DVT risk factors, you may want to talk with your doctor before embarking on a long trip. They may suggest you use anticoagulants, wear compression stockings to keep blood from pooling in your legs, or take other steps to avoid blood clots.

4. Being overweight or obese

Having excess weight can put extra pressure on the lower half of your body, which can in turn increase the pressure in the veins there, according to the Mayo Clinic. Weight issues are incredibly complex, though, and this absolutely doesn’t mean that being overweight or obese guarantees that you’ll get DVT, Dr. Fischer says. Just like everything else on this list, your risk is intertwined with how many other risk factors you have.

5. Smoking

Lighting up damages a whole host of your body’s processes, and your circulatory system is no exception. Smoking can harm the lining of your blood vessels and also make it more likely that platelets in your blood will stick together, both of which can contribute to excessive blood clotting, according to the American Heart Association. But quitting smoking is usually easier said than done. Here are seven tips to get you started, and you can always ask your doctor for more specific advice. “It’s definitely worth quitting smoking for your overall health,” Dr. Evans says.

6. Being older

While people of any age can get a blood clot, the Mayo Clinic lists being older than 60 as one one of the major risk factors for developing DVT. The reasons for this aren’t well understood, Dr. Evans says. However, it may simply be that, as you get older, you’re more likely to develop other health conditions or illnesses that increase your risk of developing DVT, like cancer, Dr. Fisher says. It also may simply be that your blood has more potential to coagulate as you get older, he says. Still, there’s a lot of uncertainty around this one.

“Even healthy elderly patients are at higher risk of clots than their younger counterparts,” Dr. Evans says. “There is something about the biology of aging that increases clotting potential. ”

7. Having surgery or getting injured

Surgery causes injury to your blood vessels, and in the process of your body trying to repair that vessel, a clot can form and travel, Dr. Fischer says. Lying in bed after an operation also increases your risk since you’re not moving as much. (This is why doctors generally recommend that you try to get up and be active as soon as medically advised after your operation.)

Given that most clots form in your lower extremities, having surgery on your hips or legs tends to put you at the greatest risk because your blood can easily slow or get stagnant down there post-op, Dr. Evans says.

Around four in 10 people who don’t receive medication to prevent blood clots will get DVT within one or two weeks of getting major knee or hip surgery, according to the U.S. National Library of Health. When you’re having surgery, be sure to ask your doctor what you can do to lower your risk of DVT, especially if you have other risk factors.

8. Having a clotting disorder

Some bleeding disorders, like hemophilia and idiopathic thrombocytopenic purpura (ITP), cause your blood to not clot enough. Others, like Factor V Leiden, fall on the opposite side of the spectrum. These can make your blood hypercoagulable, meaning it clots way too easily. While the symptoms vary by condition, if they do in fact lead to a blood clot or pulmonary embolism, you can expect typical symptoms like warmth, tenderness, redness, shortness of pain, a rapid heartbeat, and chest pain, according to the Mayo Clinic.

9. Having had DVT or pulmonary embolism in the past, or having a family member who has.

If you’ve experienced either of these conditions in the past, your doctor has likely advised you of your ongoing risk and how to keep it as low as possible. But having family members with DVT or pulmonary embolism is also a risk factor, according to the Mayo Clinic, so be sure to bring that up with your doctor if necessary.

10. Having inflammatory bowel disease

It sounds strange, but inflammatory bowel diseases like Crohn’s disease or ulcerative colitis raise your risk of getting a blood clot. A 2015 research paper in Thrombosis Journal says experts haven’t pinpointed a single cause behind why IBD can cause clotting issues but notes that people with these conditions may have genetic or immune abnormalities that can lead to difficulty with the coagulation process.

11. Having cancer or undergoing cancer treatment

Cancer also increases a person’s risk of having blood clots. “In general, the body’s clotting system gets exaggerated in people who have cancer,” Dr. Evans says. Specifically, various types of cancer may increase proteins that cause clotting, according to the American Heart Association.

So, you have one or more risk factors. What’s next?

Having a detailed conversation with your doctor about your concerns is a great step. They can help you figure out how to reduce your modifiable risk factors, like smoking and being inactive, Dr. Fischer says.

And if you suspect you have DVT or a pulmonary embolism, go to your local emergency room immediately. Doctors will examine you and run any tests necessary, then treat you with medications or procedures to break up the clot. These issues can be deadly when left untreated, so don’t hesitate to seek treatment—time is of the essence here.

Related:

Preventing Deep Vein Thrombosis From Travel | CS Mott Children’s Hospital

Topic Overview

What is deep vein thrombosis (DVT)?

Deep vein thrombosis (DVT) is a blood clot in a deep vein, usually in a leg. A DVT is dangerous because the clot can break loose, travel through the bloodstream, and block blood flow to the lungs (pulmonary embolism). Without treatment, this can be deadly.

Why does travel raise your risk of DVT?

Sitting still for 4 or more hours slows down the blood flow in your legs. This makes your blood more likely to clot. And for the next few weeks, your blood clot risk stays higher than normal.

Even if you are healthy and have a low risk of blood clots, a long flight or road trip raises your risk of DVT.

If you already have a risk of blood clots, prolonged sitting raises your risk even more. Things that can already be raising your risk for DVT include a past DVT or pulmonary embolism, a recent surgery or injury, a blood clotting disorder, and cancer. Things that pose a small risk of DVT include pregnancy, taking hormones for birth control, or hormone therapy.

How can you prevent DVT from travel?

During a long trip (such as 4 or more hours):

• If you are traveling by car, stop every hour or so. Get out and walk around for a few minutes. If you are traveling by bus, train, or plane, get out of your seat and walk up and down the aisle every hour or so.
• While you’re sitting, raise and lower your toes, keeping your heels on the floor. Then raise and lower your heels, keeping your toes on the floor. Do this every 20 minutes.
• Wear loose-fitting clothes that aren’t tight around your waist or your legs.

If you already have a risk of blood clots, talk to your doctor before taking a long trip. Your doctor may want you to wear compression stockings or take blood-thinning medicine.

When to call a doctor

For a few weeks after a long flight or trip, be alert for signs of a blood clot. A DVT needs treatment right away.

Call
911
or other emergency services if you:

• Suddenly have shortness of breath and/or chest pain. Chest pain from a blood clot that travels to the lungs (pulmonary embolism) often gets worse with deep breathing.
• Cough up blood.
• Faint or lose consciousness.

Call your doctor right away if you have:

• Swelling, warmth, or tenderness in the soft tissues of your leg.
• Pain in your leg that gets worse when you stand or walk. This is especially important if there is also swelling or redness in your leg.

References

Other Works Consulted

• Agency for Healthcare Research and Quality (2008). Your Guide to Preventing and Treating Blood Clots (AHRQ Publication No. 08-0058-A). Rockville, MD: Agency for Healthcare Research and Quality. Also available online: http://www.ahrq.gov/consumer/bloodclots.htm.
• Chandra D, et al. (2009). Travel and risk for venous thromboembolism: Meta-analysis. Annals of Internal Medicine, 151(3): 180–190.
• Kahn SR, et al. (2012). Prevention of VTE in nonsurgical patients: Antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141(2 Suppl): e195S–e226S. DOI: 10.1378/chest.11-2296. Accessed June 19, 2015.
• U.S. Department of Health and Human Services (2008). The Surgeon General’s call to action to prevent deep vein thrombosis and pulmonary embolism. Available online: http://www.surgeongeneral.gov/library/calls/deepvein/index.html.

Credits

Current as of:
August 31, 2020

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD – Internal Medicine
E. Gregory Thompson MD – Internal Medicine
Martin J. Gabica MD – Family Medicine
Adam Husney MD – Family Medicine
Jeffrey S. Ginsberg MD – Hematology

Current as of: August 31, 2020

Author:
Healthwise Staff

Medical Review:Anne C. Poinier MD – Internal Medicine & E. Gregory Thompson MD – Internal Medicine & Martin J. Gabica MD – Family Medicine & Adam Husney MD – Family Medicine & Jeffrey S. Ginsberg MD – Hematology

Clots and Travel – Hematology.org

Blood clots can sometimes form in your legs during air travel because you are immobile for long periods of time, often sitting in cramped spaces with little leg room. The clinical term for this type of blood clot is deep vein thrombosis (DVT). The longer the flight, the more at risk you are for developing a clot. Flights lasting 8 to 10 hours or longer pose the greatest risk.

In some cases, the DVT will dissolve and go away on its own. However, in more serious cases, it can cause pain, swelling, and warmth of the affected leg, or it can break off and travel to the blood vessels of your lungs, causing pulmonary embolism (PE).

DVT and PE, collectively known as venous thromboembolism, are highly preventable (see prevention tips below). The U.S. Surgeon General has issued a Call to Action on DVT and PE to raise public awareness of these blood conditions and increase research on the causes, prevention, and treatment.

There are several symptoms that can be warning signs of blood clots, including the following:

• Swelling of the leg, ankle, or calf
• Redness or discoloration
• Increased warmth over the skin 

Am I At Risk?

Your risk of developing a blood clot during air travel is increased by the following:

• Use of oral contraceptives
• Pregnancy
• Certain cancers
• Certain recent surgeries
• Age (increased risk for people over age 60)
• Obesity
• History of previous blood clots
• Family history of blood clots
• Smoking
• Trauma
• Chronic inflammatory diseases
• Diabetes
• High blood pressure
• High cholesterol
• Prior central line placement

How Can I Prevent Blood Clots When I Travel?

There are some simple steps you can take to avoid developing a blood clot while flying. Make sure to stretch your legs and get some exercise. You can do this by walking around the plane every few hours and changing positions in your seat.

If you plan on traveling soon and have concerns about getting a blood clot, talk with your doctor about your risks and prevention. Depending on your physical condition, genetics, and medical history, you may want to see a hematologist, a doctor who specializes in blood conditions.

Deep Vein Thrombosis: A Patient’s Journey

Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few other resources that may be of some help:

Results of Clinical Studies Published in 

Blood

Search Blood, the official journal of ASH, for the results of the latest blood research. While recent articles generally require a subscriber login, patients interested in viewing an access-controlled article in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.

Patient Groups

A list of Web links to patient groups and other organizations that provide information.

Blood Clots – Causes, Symptoms, Treatment, Diagnosis

The Facts

Blood clots are a collection of sticky blood cells that form when a blood vessel is damaged. The body creates blood clots as a normal response to blood vessel damage. The main job of a blood clot is to seal the leak in a damaged blood vessel. This prevents the blood from leaking out and protects the person from bleeding.

Clots (or thrombi) that block the arteries and prevent flow of blood and oxygen to an organ can lead to areas of tissue damage (infarcts). When blood clots break away (called an embolism) from the area they’re meant to protect, they can endanger other organs.

Clots that block blood flow are the main culprits in most heart attacks and strokes. They can also damage other organs:

• When a blood clot (thrombus) forms in one or more arteries that supply blood to the heart, it blocks the blood flow to a part of the heart muscle, reducing or completely cutting off the oxygen supply to the cells in that area. As a result, the part of the heart muscle that is deprived of oxygen dies, and a heart attack occurs.
• Clots that block the flow of oxygen to the brain are the primary cause of strokes.
• Clots that form in the eye may cause sudden blindness.

Presence of an obstructing blood clot (thrombus) is referred to as thrombosis. Thrombosis in a vein is almost always associated with phlebitis (inflammation of a vein). Thrombophlebitis is an inflammation of a vein in the area where a blood clot has formed.

Thrombophlebitis is classified as either superficial or deep. In other words, thrombosis can affect either superficial (surface) or deep (below the surface) veins, causing thrombophlebitis.

Superficial thrombophlebitis occurs when a blood clot affects veins near the skin surface, or superficial veins.

Deep venous thrombosis (DVT) occurs when a blood clot affects deeper, larger veins, such as those in the lower legs and thighs. DVT is more worrisome than superficial thrombophlebitis. These clots can break away (called emboli) from a blood vessel and cause a pulmonary embolism if they travel to the lung. (For more information on pulmonary embolism, see the section “Symptoms and Complications.”) DVT is more common for people over 40 years of age.

Causes

Blood clots are the result of:

• Disruptions in blood flow (due to a blockage)
• Injury to the blood vessels
• Changes in blood composition (e.g., too many clotting factors in the blood)

Ischemic strokes (strokes caused by blood clots blocking an artery that supplies the blood to the brain) can be due to blood clots that have formed in the heart as a result of rhythm disorders known as atrial fibrillation and atrial flutter.

Atrial fibrillation is a type of an irregular heartbeat (arrhythmia) that triggers a rapid, quivering beat in the upper chambers of the heart (the atria). This irregular pumping may cause some blood to remain in the heart chamber and form clots, which can then travel to the brain. Emboli can also form at the site of artificial heart valves, after a heart attack, or as a result of heart valve disorder or heart failure.

Cardiogenic embolism refers to clots that form inside the heart and travel to the brain. A stroke may occur in someone who has suffered a heart attack. A heart that has been damaged by a heart attack doesn’t pump blood properly, which can cause formation of a blood clot that travels to the brain. The presence of artificial replacement heart valves can also lead to blood clot formation.  People with artificial heart valves can take blood-thinning medications to help to prevent clots from forming.

Some blood clots may form in a narrowed artery as a result of atherosclerosis, commonly known as hardening of the arteries. In this case, the arterial walls slowly thicken, harden, and narrow over time until blood flow is reduced. As a result, these arteries become vulnerable to injury. If they tear, a blood clot may form, completely blocking the already narrowed artery and shutting off oxygen to part of the heart or brain.

Blood clotting problems and rare blood disorders also cause blood clots to form, but the cause of blood clots is not always known.

For some women, the use of oral contraceptives (birth control pills) may increase the risk of blood clot formation. The risk is higher for women over 35 years of age who smoke or have a history of previous blood clots.

A variety of things can cause inflammation of a superficial vein. One common cause is due to trauma or injury, for example from solutions or medications given intravenously (into a vein) in hospitals. Piercing the vein to give the solution or medication can cause irritation. Any trauma to a vein (such as an injury from a car accident) will trigger inflammation in the area, leading to pain, discomfort, redness, and swelling. During this process, there is increased blood flow to the injured area, and a blood clot often forms in the inflamed or injured area of the vein. Superficial thrombophlebitis is an uncomfortable condition but rarely causes serious problems.

Sometimes, thrombophlebitis is caused by a bacterial infection in the vein. The usual culprit is a bacteria called Staphylococcus, commonly found on the skin.

In certain cases, thrombophlebitis develops without an obvious reason. It may develop in the leg veins of pregnant women, in people with varicose veins, and in some people with cancer in the abdomen (particularly the pancreas). Women over the age of 35 years who smoke and take oral contraceptives (birth control pills) are at a higher risk of developing blood clots.

DVT occurs when blood clots form in the deep veins of the legs or pelvis, and is often caused by:

• prolonged sitting or bed rest
• surgery or trauma (especially hip surgery, gynecological surgery, heart surgery)
• medications such as estrogen, and birth control pills with higher levels of estrogen
• injury to the leg or immobilization (such as casting after a broken bone)
• hospital admission (current or within the past 3 months)
• cancer and cancer-related treatment
• infection

Certain inherited conditions can make DVT more likely to occur. Blood flow in the veins depends on contraction of surrounding muscles, and with inactivity, such as extended bed rest, the blood starts to collect and blood clots can easily form.

Symptoms and Complications

Blood clots that result in a heart attack may cause chest pain (angina) that usually starts in the centre of the chest and moves to the jaw, the back, the left arm, or occasionally the right arm. Less commonly, the pain may be felt in the abdomen.

Heart attack pain is usually severe but not always. Some people have “silent heart attacks” without any symptoms. Some people have reported feeling a sense of impending doom as a heart attack comes on. There’s tightness and often a pounding in the chest. The heart may speed up and beat irregularly. Shortness of breath or difficulty breathing, nausea or vomiting, fainting, or collapse may also occur.

Women may experience slightly different heart attack symptoms than men. Women are more likely than men to have nausea, and less likely to have sweating as a symptom of a heart attack. Women may not feel the chest pain as distinctly as men. The most common places for women’s chest pain to spread to are the neck, jaw, or back.

Blood clots that result in a stroke usually cause symptoms on the opposite side of the body from where they are causing the blockage in the brain. This may result in loss of feeling on one side of the face, arm or leg, or blindness. If the left side of the brain is affected, speech problems can occur. Affected people may be unable to speak or to understand spoken words. Other symptoms of stroke include confusion, blurred vision, a severe headache, or sudden loss of coordination or balance.

Signs of stroke should not be ignored, however brief or seemingly insignificant. Even if symptoms only last a few minutes and then vanish completely, it is important to seek medical attention right away.

Inflammation in superficial or surface veins (such as those used to insert intravenous [IV] lines in the arm or to draw blood) produces pain and discomfort but it usually isn’t considered serious. Blood clots that form in superficial veins rarely break loose and travel in the blood to cause blockage (thromboembolism) and complications in organs such as the lungs.

In the case of DVT, a blood clot in the leg may cause pain, swelling, redness, and increased warmth. The leg may ache when standing. This usually occurs in one leg only. While many people with DVT have no signs or symptoms, the classic symptoms are:

• firm swelling
• pain or tenderness over a vein
• sharp pain when the foot is flexed upwards
• redness
• warm sensation over the affected area
• dull, aching tightness in the calf, especially with walking
• dilation (widening) of the surface veins of the leg

DVT can lead to serious complications. A blood clot that formed in deeper and larger veins, such as those of the legs, abdomen, and pelvis, can break away and become a travelling blood clot, or embolus. The embolus can travel and lodge in the lung, a condition called pulmonary embolism.

Because a clot in a deep vein may not cause symptoms early on, the first sign may occur when the clot has broken loose and travelled to the lung. Symptoms of a pulmonary (lung) embolism are breathlessness, chest pain, and bloody sputum. If you have any of these symptoms, get emergency medical care right away.

Making the Diagnosis

Tests to check for presence of blood clots may include:

• computed tomography (CT or CAT scan; a special technique that uses a computer to combine many X-ray images into a detailed image of an area body that is 100 times more clear than a regular X-ray)
• magnetic resonance imaging (MRI)
• ultrasound studies of leg veins or the arteries of the head and neck
• angiograms or venograms
• an ultrasound of the heart (echocardiogram)
• electrocardiograms (ECGs)

Certain specialized blood tests may indicate if someone has had a recent heart attack. You may need to be screened for thrombophilia (a disorder in which blood abnormally coagulates, leading to an increased risk of blood clots) if you have a family history of thrombophilia or are under 40 years of age and experiencing recurrent blood clots.

Superficial thrombophlebitis is usually diagnosed according to your symptoms. A doctor will take your medical history by asking about your symptoms and conducting a physical examination.

In the case of thrombophlebitis, an ultrasound of the suspected veins may be done to confirm the diagnosis. Since the leg pain associated with DVT is very similar to muscle pain, your doctor might look for signs of swelling and enlargement of the calf due to swollen leg veins.

A diagnosis of DVT is usually confirmed with a compression ultrasound. Compression ultrasound detects differences in echoes or sounds made by flowing blood, and can easily detect the presence of blood clots in deep veins.

Treatment and Prevention

Medications are usually used to stop progression of DVT and prevent the blood clot from worsening, breaking away, and moving to the lungs. If you think you may have DVT, seek medical attention right away.

Blood-thinning medications such as warfarin*, heparin (either unfractionated heparin or low molecular weight heparins, like enoxaparin, dalteparin, or tinzaparin), fondaparinux, or oral anticoagulants (e.g., dabigatran, rivaroxaban, apixaban, edoxaban) are usually recommended. The choice of blood thinner is highly individualized; it is based on medical history, preference, other health issues, cost, and convenience. These medications may be continued for several months after a blood clot has been diagnosed. The length of treatment usually depends on whether it was a first episode or a recurrent event, whether the event was brought on by a specific issue or not, and whether there are other health issues (e. g., active cancer).

Most people do not require admission to a hospital to treat DVT, and those with DVT can usually return to normal activities within 2 to 3 weeks.

For some people, long-term treatment with warfarin (an anticoagulant) or oral anticoagulants (e.g., dabigatran, rivaroxaban, apixaban) may be necessary to prevent new blood clots from forming. Your doctor may also recommend that you wear an elastic compression stocking on your leg to prevent DVT. Painkillers may be used to reduce the pain.

To relieve mild inflammation and discomfort, the affected area should be elevated and warm, moist packs applied for 15 to 20 minutes at a time throughout the day. For people with superficial thrombophlebitis, activities such as walking are recommended. If the inflammation and symptoms last longer than a day or two, or if symptoms become worse, see a doctor as soon as possible.

In cases where the thrombophlebitis is due to an infection, treatment with antibiotics often takes care of the problem. In rare cases, when the antibiotics aren’t enough to control the infection, surgical removal of the inflamed portion of the vein may be required.

To help prevent DVT, avoid long periods of immobility such as those during long car trips or airplane flights. Try to walk around and stretch for a few minutes every hour or so. Elevate your legs above your heart level if possible, and if you have a history of blood clots, wear support stockings or socks.

Prevention of blood clots is the best way to deal with the problems of heart disease and stroke. It is important to reduce or quit smoking and to control high blood pressure. High cholesterol levels also present a risk for blood clots and may be checked by your doctor. A healthy diet and regular exercise also help to reduce the risk of heart attack and stroke.
For more information, see our articles on heart attack and stroke.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Blood-Clots

The Risk of Blood Clots – Services

Do Blood Clots in My Leg Pose a Risk?

We have all heard about the dangers of blood clots, ranging from heart attack and stroke to less critical issues like swelling in the legs and ankles. How do blood clots differ in severity?

Sometimes a clot occurs in the superficial venous system. This is referred to as superficial thrombophlebitis. It is rarely serious and the clot usually dissolves on its own, though it’s always a good idea to check with your healthcare provider if you are having any symptoms such as warmth and tenderness – or redness and swelling – of a particular area, generally in your legs and feet.

Superficial thrombophlebitis symptoms tend to be localized. This means that they occur in the direct vicinity of the actual clot. You may even notice a raised, cord-like vein under the skin.

Deep vein thrombosis (DVT) is a condition where a blood clot forms in the deep veins. While there are no known specific causes for DVT, factors that may put you at a greater risk are:

• Being inactive for long periods of time, including prolonged bed rest
• Major surgery (especially knee replacements)
• Hereditary clotting disorders or a family history of blood clots
• Older age
• Certain medications (your doctor or pharmacist can alert you to any risks when prescribing medications for you)

If you have a deep vein thrombus (clot), it’s considered a medical emergency and you should head straight to the emergency room. Symptoms of DVT are:

• Swelling of the whole leg
• Changes in skin color, including redness, bluish, or pale appearance
• Pain in your leg that may start out as a cramping feeling
• Warmth of the skin

If you experience any of these, get to the emergency room as quickly as possible.

Pulmonary Embolism and Deep Vein Thrombosis at UC San Diego Health

Care for Blood Clots in the Lungs and Legs

Pulmonary embolism (PE) is a blockage in an artery in the lungs as a result of a blood clot (thrombus).

Pulmonary embolism is often caused by deep venous thrombosis (DVT), a condition where blood clots form in the deep veins of the legs. Deep venous thrombosis results in PE when the clots break off, travel up to the lungs and get stuck in the arteries, creating a blockage.

Venous thromboembolism, a term that includes both pulmonary embolism and deep venous thrombosis, can be provoked by a combination of hereditary and acquired risk factors. There are approximately 600,000 cases of venous thromboembolism in the U.S. every year.

Things that can increase your risk for PE and DVT:

• Family history of blood clots or clotting disorders
• Being overweight
• Smoking
• Cancer and cancer therapy
• Age (older adults have a higher risk)
• Medical conditions such as heart disease, hypertension, inflammatory bowel disease (IBD) and COPD

• Childbirth (during and after pregnancy)
• Severe injuries in the thigh or hip area
• Brain, joint or bone surgery
• Medications such as estrogen therapy and birth control pills
• Enlarged veins in the legs
• Hospitalization

Symptoms of Pulmonary Embolism (PE)

Shortness of breath is often the first warning sign of pulmonary embolism.

Since shortness of breath can be a result of many different lung problems, it’s important that you meet with a specialist who can provide an accurate diagnosis.

Some people with pulmonary embolism may also experience chest pain that is:

• Sharp and stabbing
• Worse as you breathe deeply
• On one side or underneath the breastbone
• Dull, aching or burning

Other symptoms that may indicate pulmonary embolism include:

• Fast heart rate
• Sudden cough
• Coughing up blood
• Clammy skin, excessive sweating

• Low blood pressure
• Bluish skin
• Fainting or dizziness
• Anxiety

If you have any of these symptoms, don’t wait for an appointment with one of our pulmonary specialists –
go to the ER!

Why is Treating Pulmonary Embolism Critical?

Acute pulmonary embolism can be life-threatening.
It is the third most common cause of death from cardiovascular disease after heart attack and stroke. Acute pulmonary embolism requires immediate treatment with anticoagulant medications.

Despite treatment with anticoagulants, nearly a third of people with acute pulmonary embolism will have some amount of scarring in the lung arteries that can cause chronic problems. In a small portion of people, scarred lung arteries eventually develop into chronic thromboembolic pulmonary hypertension (CTEPH).

CTEPH refers to repeated blood clots in the pulmonary arteries that do not dissolve with medication. These clots become fibrotic and scarred and permanently attach to the blood vessel wall. Approximately 1-3 percent of people with pulmonary embolism will progress to CTEPH.

Diagnosing Pulmonary Embolism

It can be difficult to diagnose pulmonary embolism (PE) as symptoms overlap with many other diseases and conditions (e.g., COPD, irregular heartbeat, asthma).

Often, diagnosis is made in the emergency room (by a doctor and radiologist) when symptoms demand immediate medical care.

There are three factors used to diagnose pulmonary embolism:

1. 
   Your medical history   
   
   The first step of diagnosis is determining how likely it is that you have pulmonary embolism. This involves ruling out other possible causes of your symptoms, as well as evaluating your risk factors for pulmonary embolism and deep vein thrombosis (DVT).
2. 
   Physical exam
   During the physical exam, the blood pressure of your heart and lungs will be checked, and your legs assessed for signs of deep venous thrombosis (e.g., swelling of leg or along a vein).
   Signs of deep vein thrombosis.
3. 
   Diagnostic tests
   Our team has advanced diagnostic tools to diagnose pulmonary embolism. Depending on your symptoms, one or several of these procedures may be performed during your exam.

• Computed tomography (CT) scan of the chest and legs
• Ultrasound
• Ventilation perfusion scan (VQ scan)
• Blood tests
• Electrocardiogram (EKG)

Treatment of Pulmonary Embolism

A pulmonary embolism that does not resolve on its own can be life-threatening. For these cases, medication or surgery (rarely needed) is used to break up the clot.

There are two goals of pulmonary embolism treatment:

1. Keep the existing blood clot from causing damage
2. Prevent the formation of new clots

Anticoagulant Medicines

A pulmonary embolism is typically treated with anticoagulants, or “blood thinners.” Despite its nickname, anticoagulants don’t actually thin your blood – they stop your body’s ability to clot. This helps keep existing clots from getting bigger.

While anticoagulants do not break up clots that have already formed, your body can usually dissolve clots on its own over time.

Anticoagulants come in the following forms:

Newer oral anticoagulants (e.g., apixiban, rivaroxabin, dagibatran) that do not require monitoring are available for some patients in with low risk of bleeding.

The most common side effect of warfarin is excessive bleeding, which can be fatal. To prevent this, routine blood tests
PT (prothrombin time) and
PTT (partial thromboplastin time) will be performed. These tests measure the blood’s ability to clot.

Other Types of Therapy

Other forms of treatment may be necessary in cases whene:

1. Pulmonary embolism is causing critical illness
2. Patient is unable to take anticoagulant medicines

In these situations, the following therapies may be recommended:

• 
  Tissue plasminogen activator (tPA): A clot-dissolving medication.
• 
  Ultrasonic catheter: Administered by interventional radiologist. Helps break up clot with ultrasonic waves. Often used jointly with tPA.
• 
  Surgical embolectomy: Blood clot is removed with surgery.
• 
  Vacuum catheter: A tiny vacuum is threaded through the veins and used to draw out blood clots.
• 
  Inferior vena cava (IVC) filter: A small, cone-shaped device designed to catch blood clots is implanted by an interventional radiologist in the inferior vena cava, the large vein that carries blood back to the heart, using a catheter. This minimally invasive procedure is done while the patient is awake. An IVC filter can be permanently or temporarily implanted.

While an IVC filter cannot prevent new blood clots from forming, it can help prevent deep venous thrombosis from moving into your lungs.

​Deep Venous Thrombosis (Deep Vein Thrombosis)

About Blood Clotting

Blood clotting is a normal and important process that helps stop excessive bleeding. However, slow-moving blood flow, blood vessel wall injuries, or a defect in clot forming can cause abnormal clotting in the arteries and veins. Our pulmonologists work closely with the anticoagulation clinic to determine length and level of therapy. 

Bleeding disorders and how we treat them

Deep venous thrombosis (DVT) refers to blood clots that form in the deep veins in the legs.

Deep venous thrombosis is the most common cause of pulmonary embolism.

Some people have no symptoms when clots form in their legs, while others have severe, debilitating symptoms. Deep venous thrombosis usually affects deep veins in the thigh, lower leg and pelvis, and less commonly, the arm.

People with deep venous thrombosis may experience one or several of the following symptoms in the affected area:

• Tenderness
• Leg pain
• Redness and changes in skin color
• Skin that is warm to the touch
• Leg swelling

Long-Term Management after Pulmonary Embolism

​See a Specialist

Meeting with a specialist who can determine your risk for more blood clots and diagnose the cause of your shortness of breath may reduce your need for invasive surgeries later.

The pulmonary embolism experts at UC San Diego:

• Pinpoint the cause of your blood clot
• Ensure you have completely recovered from the blood clot
• Select the best therapy for you
• Determine length of therapy

• Assess your risk of recurrence
• Manage your anticoagulants around future operations
• Perform diagnostic testing (in the event you have shortness of breath)

The most important aspect of long-term care after a pulmonary embolism is reducing the risk for a recurrent pulmonary embolism.

​Blood Clot Risk

To fully assess your risk of blood clot recurrence, our team may:

1. Develop a thorough history in order to determine the risk of future blood clots.
2. Do blood tests to see if you have hypercoagulability (a tendency to form clots).
3. Perform additional imaging tests.

After calculating your risk, we will work with you to determine a personalized preventive plan that includes recommendations for medication and length of treatment.

​Shortness of Breath

After pulmonary embolism, some people continue to experience shortness of breath. If you are having symptoms of breathlessness, it’s important that you follow up with a specialist who can properly evaluate your condition and rule out recurrent pulmonary embolism.

Our pulmonary experts assess shortness of breath with:

• Cardiopulmonary exercise testing
• VQ SPECT
• Echocardiogram

In many cases, further analysis may be needed to identify the cause. We provide comprehensive diagnostic testing in our
Pulmonary Function & Exercise Lab.

​Other Prevention Tips

You can help prevent deep venous thrombosis by:

• Limiting the amount of time you spend in bed when ill or recovering from surgery.
• Taking medicines that help prevent blood clots (e.g., anticoagulants).
• Regularly participating in physical activity.
• Exercise/move leg muscles when forced to sit for long periods of time.
• Wearing compression stockings that promote blood flow in your legs.

Clinical Research

Our physician-scientists are active in clinical research including clinical trials investigating:

• Prevention of blood clots following hospitalization (APEX study).
• The link between acute pulmonary embolism and CTEPH.

We also participate in registry studies for pulmonary embolism. These studies allow us to gather data from multiple accredited medical centers to help provide a clearer understanding of the disease progression of pulmonary embolism and outcomes for different therapies.

UChicago Medicine doctors report an increased risk of blood clots in patients with COVID-19

Occasional stiffness or soreness in your legs might not require a visit to the doctor, but leg pain or fatigue that develops after you’ve been walking or climbing stairs could be a sign of a vascular disease. Vascular surgeon, Chelsea Dorsey, joins interventional cardiologist, Jonathan Paul, and vascular and interventional radiologist, Osman Ahmed, to discuss how to detect, treat, and prevent a variety of vascular diseases. We’ll also take your questions live. Coming up now on At the Forefront Live.

[MUSIC PLAYING]

We’re going to remind our viewers that today’s program is not designed to take the place of a visit with your physician. If you have questions for our physicians, please type them into the comments section, and we’ll get to as many as possible over the next half hour. Thanks for joining us today. We appreciate you being on.

Glad to be here.

Thank you.

So let’s just start out with the basics, and I’m going to have each of you introduce yourselves to our audience, and tell us a little bit about what you do here at UChicago Medicine. And Dr. Paul, we’ll start with you.

Great. I’m Jonathan Paul. I’m an interventional cardiologist here university Chicago Medicine. I specialize in treating a wide variety of cardiovascular diseases via interventional techniques, using catheters and small devices to treat a number of vascular diseases, including coronary artery disease. I have a particular interest in venous disease, in treating patients with pulmonary embolism, and deep vein thrombosis. And we have an interesting array of technologies to address those issues as well.

Fantastic. Dr. Dorsey.

Hi. Again, I’m Chelsea Dorsey. I am in the section of vascular surgery here at UChicago Medicine. I’m actually the director of our vein clinic here at UChicago Medicine. I’m very excited to be here today to talk to you a little bit about some of the services we have. We see a ton of patients in our vein clinic with conditions such as varicose veins, venous insufficiency, venous status ulcers, and so I’m very excited to talk to you a little bit about what we can do for patients with those conditions.

Great. Dr. Ahmed, you’re our veteran. You’ve been on twice now.

Hi, everybody. I’ve Osman Ahmed. I also go by Oz. I’m a vascular and interventional radiologist. And similar to Dr. Paul, we work by doing procedures in minimally invasive methods with wires and catheters. I also, similarly, have a particular interest in treating venous disease. Specifically, deep vein thrombosis, both acute and chronic, in addition to placing and removing IVC filters.

All right, let’s start off with the basics, and just what our vascular diseases? What’s the difference between arterial and venous conditions?

Yeah. So I can answer that question. Vascular disease is a pretty broad term that we use. Basically, it encompasses any condition that affects the arteries and veins in our body– the blood vessels. Arteries are the blood vessels that carry the oxygenated blood that’s nutrient rich to the different tissues around our body. The veins bring the blood back to the heart when it’s deoxygenated.

So I’ve kind of described the functions of the arteries and veins, and you can see they’re quite different. And as you can imagine, the conditions that affect the arteries and veins are also quite different. So a lot of times, when we start talking about vascular disease, we often talk about coronary artery disease, which happens in the arteries, and causes people to have heart attacks. And sometimes we talk about peripheral arterial disease.

So that’s what patients have poor circulation in their legs to cause them to have pain and ulcers that don’t heal. We’re actually really excited to be here today to talk about some of the venous conditions that patients experience. As I stated at the beginning of the show, I’m the director of the UChicago Medicine Vein Clinic, and we’re in the process of kind of expanding our services there. And the three of us are actually involved in another program called the Comprehensive Venous Thrombosis and Pulmonary Embolism program. So we’re really excited to talk to you about all of those.

Fantastic. So what are the most common venous conditions? Dr. Paul, if you’ll take that one. So venous conditions really can present in a number of different ways. Probably, the most well known or well described venous condition would be just venous insufficiency, which is where a patient has, typically, a swollen leg, a painful, heavy leg that is sort of just always causing them some discomfort. There are always some issues with feeling soreness and heaviness, and the patient always sort of asking doc, is there anything I can do about this? That’s typically due to an issue with the vein, and the ability of the vein to drain the blood effectively back to the heart, as Dr. Dorsey had described.

Oftentimes, that condition is due to a problem with the valves inside the veins. And so the valves are essentially there to help the blood make their way back up to the heart. If there’s an issue with the veins becoming what we call incompetent, or have an inability to close properly, then the blood will essentially pool within the veins of the legs, and cause what we call venous insufficiency, or swelling of the leg.

Another common venous condition is deep vein thrombosis. This is a very common condition where a blood clot will form within a vein, deep down within typically the legs. Oftentimes, it happens in the legs– lower down within the leg, but it can also happen higher up. Deep vein thrombosis can also happen within the main vein that drains back into the heart, which is called the inferior vena cava. Or else it can happen up in the arms, or in the veins in the neck. So deep vein thrombosis can happen, really, anywhere within the body.

And typically, results in a painful, swollen extremity, typically a leg. It can be a dangerous condition because deep vein thrombosis can result in that blood clot breaking off, and traveling up through the body into the heart, which causes what we call a pulmonary embolism. And that’s what I have a particular interest in treating. Pulmonary embolism, as we’ll talk more about in a little while, is a condition where that clot, essentially, will block blood flow within the lungs, and can be very, very dangerous. It can cause patients to come in with significant shortness of breath, trouble breathing, and chest pain, and occasionally, it can be life threatening. So if deep vein thrombosis is a serious condition.

Yeah, and I do want to talk more about that as we progress through this show, and of course, we’ll tell people what to what to look for, and want to be aware of, and how to prevent these things. So is a deep vein blood clot– is that the same thing?

It’s the same thing, yeah. DVT is that is the terminology that’s typically used in the medical community, but blood clot, clot, DVT, they’re all interchangeable.

So Dr. Ahmed, how do you prevent blood clots? What can you do?

Yeah, that’s a great question. So I would say the short answer really is to live a healthy lifestyle. So the most important thing is if you’re overweight, you want to try to exercise and lose weight, and also try to remain active, and healthy as well. So just through basic exercise. In addition, you want to avoid being sedentary for too long.

So when I say sedentary, I mean you don’t want to be sitting or lying down flat for a long time. In long car rides or plane trips, you want to get up and move around. And what that essentially does is it gets the blood flowing in your body, especially in your legs, where that blood tends to pool, and can form those clots. And so you really want to be able to help your body fight that gravity, and help to pump that blood back to the heart.

We were talking a little bit before the program, and I was serious about this. I actually was on a long car trip recently. About an 11, 12 hour car trip, and I did have pain in my left leg, which was something that concerned me, and I probably should have considered. What do you do in a situation like that? Because that was the thing. After it happened, I’m home on a weekend, and thinking, I don’t know if I need to do something about this or not.

I think it’s a really good point. We see patients all the time that have these very nonspecific complaints. They say my leg feels funny, like you described. Having sort of a heavy feeling or a soreness in the leg. Maybe I twisted something. Maybe I slipped. Maybe I injured my leg, but there’s not really a good explanation for it. If it happens acutely, or it happens right away without any sort of warning or predisposing factor, if it continues to stay there for more than a day or so, it’s probably worth getting checked out.

And particularly, in those scenarios. You said you were on a long trip. You should definitely have a high degree of suspicion, for sure.

Yeah, it was it was one of those situations where I had to get from point A to point B, and it wasn’t a fun trip. You just press through to the end. Probably not the smartest thing. And again, things like that can end a tragedy. We were also talking before the show. I had a colleague that I used to work with that had a situation like that, and it was fatal in that case. So something you definitely should be aware of. If you’re on an airplane, what do you do if you’re on an airplane for a long flight?

So there’s a couple different things you can do. So I definitely recommend that patients wear compression stockings when they go on an airplane. Another thing you can do is you can get up out of your seat every now. I’d say every half an hour, get up. Walk up and down the aisle. Stay hydrated during the flight as well. Stay away from coffee and alcohol, if you can. So those are probably some of the main things. You can do exercises in your chair too, kind of with your calf, moving your legs around, and that helps as well.

So what do the compression socks do?

So the compression socks basically, just like they sound like, they cause compression on the legs to help kind of pump the blood back up out of the leg. So pretty simple, but it works.

Interesting. Dr. Paul, you mentioned a moment ago that the veins– the valves and the veins. Explain that a little bit more for us, if you will, because I think a lot of people probably had no idea that that even exist.

Yeah. No, that’s a good point. Veins are very different than arteries. So we think of arteries as basically just tubes. They’re a conduit for blood to flow from point A to point B. Veins are actually very different. They’re larger structures, typically. They have valves. So you can sort of think of it as a highway with those gates that sometimes close when you’re getting on and off the express route, and those gates would essentially be the valves.

And the valves open when the blood is flowing, and they typically close when the blood is not flowing. And so if the valves don’t work properly, then blood can pool below the valves, or blood flow can get disturbed around the valves, and that can cause issues with the blood returning up from the leg. Or it can cause blood clotting as well.

Just had our first question from a viewer. It’s can flying cause blood clots? We talked a little bit about that a moment ago, but is there anything specific to flying that makes it worse? Or is it just you’re trapped in a little tiny seat for an extended period of time?

Yeah, absolutely. For the most part, it’s the length of time that you’re staying sedentary or inactive. And so as Dr. Dorsey mentioned, really, those things, which seem relatively minor, actually could end up being lifesaving because they can kind of really prevent this large blood clots performing in your legs.

And we’ll oftentimes have patients come in with a swollen leg, and they’ll say I was on a recent flight. The flight was from Chicago to Atlanta. Is that a significant length of time? And typically not. It’s usually the longer flights that we worry about. So transatlantic flights. Usually flights over about six to eight hours are more concerning than short hauls across the US.

And Tim, you had asked about compression stockings. It’s different degrees of compression for compression stockings. So I usually prescribe 20 to 30 millimeters of mercury. That’s kind of middle of the range. They get, actually, a lot tighter than that, which can be uncomfortable for some people. Once you get below that level, they’re not doing as much for you. But yes, 20 to 30 millimeters mercury is what I typically prescribe.

And is that something you just pick up at a drugstore?

So usually, you have to go to a kind of medical device companies, where they’ll measure your leg, and make sure that you have the proper size. But you can’t go to Target, Walgreens, CVS, Amazon, and order some as well.

I see.

I think a lot of sporting good companies are selling compression socks for elite athletes that run marathons. So you may see these runners that have these bright green socks, and those are usually compression socks.

That makes sense. Well, any other pieces of advice too. If you’re in your car and you’ve got a long trip, pullover on occasion, and get out of the car and walk around. That alone can make a pretty significant difference, I would imagine. So if you do have a situation where you do have a blood clot, is that always deadly? Or is that something that can be treated?

It’s not always deadly. Blood clots are common. They happen for a number of different reasons. Blood clots can happen for the issues we already discussed, such as immobility. However, some patients are more predisposed to forming blood clots, in general. Patients that have cancer, for example, are more prone to forming blood clots. Patients that have genetic abnormalities that sometimes affect how blood clots can be more prone to forming blood clots. And there’s a number of other potential causes, but they’re not– by far, not always deadly. I don’t want to give that impression at all.

Blood clots happen in the legs quite commonly. They do travel to the lungs, occasionally. And when they do travel to the lungs, about 5% of the time, they cause a serious problem. The big problem is that patients don’t always make it to the hospital when they have a major blood clot in the lungs, and those are the ones we never find out about. So if a patient makes it to the hospital with a big blood clot in the lung, we can usually treat it pretty effectively, and make it so that they’re not going to have long-term problems.

So what about people who are on blood thinners? If you’ve got a heart condition, you’re on a blood thinner, does that make you more or less susceptible?

Yeah, sure. I’ll take that one. So actually, the foundational treatment for blood clots is blood thinners. And so, really, if we can get somebody on a blood thinner if they have a blood clot, really, the majority of the time, that’s going to be enough. A lot of the treatments that we’ll probably talk about today won’t be needed, but it’s really for those patients who have a very large amount of blood clot, or actually cannot be on a blood thinner. Then we have to talk about different things that we potentially have to do to kind of intervene, and help prevent further consequences of that.

And I think most people, when they think of these venous conditions, they think of conditions with your legs, but it’s not just your legs. Is that accurate?

Yeah, absolutely. So unfortunately, blood clots can occur anywhere throughout the body. Today, we’re specifically talking about the veins. And within the veins itself, we’ve already talked about how those blood clots in your legs can break off and travel to your lungs. They can actually just propagate up, and go into your abdomen, or into your pelvis. Unfortunately, they can also occur in your neck, in your arms. A large variety of different places that they can occur, unfortunately. And we’re actually showing a screen image here of a patient with a CT scan who has a very large clot in there. What we call the IVC, which is the largest vein in your abdomen that kind of drains all the blood from your legs.

And so this is actually very similar to a case we just did recently where a patient had a large amount of blood clot like this. And as you can imagine, when you have this significant amount of clot, that’s life threatening because if that breaks off and goes to your lungs, those are the people that Dr. Paul’s mentioned that might not make it even to the hospital. So those are the types of situations where we want to try to get in, and intervene, and try to take care of that blood clot.

So what kind of symptoms would somebody be showing if they had something like this happening? What would people need to look for?

So this is a pretty extreme case here, but if someone had this issue, they would present with swelling, pretty significant pain in the lower extremities as well. Again, we don’t want everyone at home to think that they might have a clot that big just looming in their abdomen. If this were going on, you’d know it.

Sure. Pretty unusual situation. That’s good. Let’s talk about varicose veins for a moment, if we can. I think that’s, again, a fairly common thing that people think of. How serious is that, Dr. Dorsey? And can people live with varicose veins?

That’s a great question, and that’s a question that I often get in clinic when I’m talking to patients. So just to back up a little bit. Varicose veins are kind of those bulging veins that you can see on the surface of your skin, and can also feel if you’re kind of touching your leg. Varicose veins, spider veins, they usually come about because of the issue that we talked about earlier, which is venous insufficiency.

To answer your question, yes, you can live with their varicose veins. People can be kind of anywhere on a spectrum with respect to their varicosity. So some patients have no symptoms whatsoever. Some patients really, get a lot of aching, throbbing, fatigue, heaviness in their leg because of this issue, and that can affect them if they’re on their feet a lot during the day as a caregiver or for work. And then some patients don’t like the appearance of the varicose veins too. So at the vein clinic, we really try to take each person individually, and try to figure out a management plan that’s appropriate.

So whether that’s sitting down and just kind of talking about the severity of the condition. In some patients, it’s just kind of preventing things from getting worse. But we also do a lot of minimally invasive procedures as well for patients who are a little bit more symptomatic, or if they don’t like, again, the appearance. So the photo that they’re showing you now is a patient in our procedure room as they’re about to get an ablation procedure for venous insufficiency.

Interesting. And so what is the ablation procedure? What does that do?

Yeah. So basically, the kind of thought there is that you close off the superficial veins that aren’t working as well, as Dr. Paul was saying. So that’s that issue the venous insufficiency, where the valves are kind of pumping properly to get the blood up and out of the leg. So the idea is you close off those veins that aren’t working well to reroute blood to veins that are working a bit better.

Interesting. We’ve got another question from a viewer. And this is how common is vascular disease in people in their 20s and 30s?

Go ahead, Ahmed

Sure. Yeah, so again, the short answer is it’s not very common. But when we do see it, it’s usually related to we have specific pathologies that we want to rule out. And pathologies is just sort of another word for a specific disease that we want to rule out. So you might hear things like thoracic outlet syndrome, or May-Thurner Syndrome. And what these are these are actually anatomic compressions in your body that actually– where the veins are getting squeezed, and causing the blood flow to be inhibited. And so we commonly see things like this in younger patients, and so when we do see blood clots or vascular disorders in those patients, we want to rule out something more than just kind of a plain, old blood clot from sitting on a plane too long.

Yeah, and I might add, also with regard to DVT or blood clots within the legs, we typically see these in younger patients that are on oral contraceptive medications. That’s a risk factor for forming deep vein thrombosis. So women on birth control. Sometimes we see younger patients that are smokers, or obese, or sort of live sedentary lifestyles that develop these deep vein clots as well.

We also see venous insufficiency and varicose veins in the young female patient. So women are at increased risk for developing this issue. Having multiple pregnancies also puts you at increased risk for getting varicose veins.

So let’s get back to– let’s talk a little bit more about various veins. The symptoms, obviously, you can see them, but what are some of the other symptoms that somebody might notice.

Sure. As I kind of described before, a lot of times it’s aching, throbbing, heaviness. A patient will just say that their leg feels really tired, and that’s particularly after they’ve been on their feet for long periods of time. Some patients will describe burning or itching overlying their varicosities. So those are kind of the typical complaints, and then swelling is also involved.

And these are things you’ll take care of in the vein clinic. What other things happen at the vein clinic? Is that fairly new?

Lots of exciting things. So we’ve had a vein clinic for a while, but we’re expanding outpatient procedures to Orland Park in South Loop now, but we do it all. We’ll focus on conservative management for some patients. So that’s making sure they’ve got good compression stockings, leg elevation, maintaining a healthy weight. Those are all really important things for vein health.

We also do sclerotherapy for spider veins. So that’s more about cosmetic procedure that we do in the office for patients with that issue. Then we do those minimally invasive ablation procedures, which you saw that photo a bit earlier. And then we do some surgical procedures as well, including phlebectomies, which is where you basically make little tiny incisions to remove the varicosities directly.

Great. Dr. Ahmed, how do you diagnose a venous condition? And I think we have some images that maybe we can– some looped images that may work with what you’re going to talk about.

Sure. Well, you’re asking the radiologist. So of course, I’m going to say the answer is imaging. The workhorse imaging modality that we use to diagnose DVT, specifically clot in the legs, is going to be ultrasound. It’s cheap, it’s fast, and it doesn’t utilize radiation as well. So this picture that we’re showing you here is a picture of an abnormal vein in your leg.

Essentially, what that’s showing you is clot there. And the way to really see this is that there’s no flow. So the next picture we’re going to show you is a normal vein, and it’s going to be very obvious, as you can see there. There’s that bright blue color that actually signifies that there is blood flow within the vessel returning towards the heart, and so that vessel is wide open with good blood flow, as opposed to the other one where there was no blood flow detected.

Interesting.

The additional modality that we use when we can’t image– so if a patient is very large, or we want image other places where ultrasound can’t reach, really is we like to use CT. And so specifically, also for Dr. Paul who is treating a lot of the PE patients, is we utilize what we call CT or CAT scan.

Great. More questions from our viewers coming in. How do you remove a blood clot? Throw that up to anybody.

Well, I’ll take that. That’s one of my favorite questions. So all three of us, we have a bunch of great options available to us to try to help patients who, when indicated, to remove that blood clot. So the main way that we try to take care of a blood clot, especially when it’s fresh or acute, is to infuse medications that essentially dissolve the blood clot like a clot-busting medication, and that’s called TPA is the most common medication that we use. If needed, or if we don’t want to give the TPA, we can actually use devices.

Again, we’re sort of like glorified plumbers. It’s just basic plumbing. Meaning, we go in there, we roto-rooter the clot out. So we have devices that actually will manually extract that clot, and Dr. Dorsey could probably speak a little bit more to that, especially from a surgical perspective. When blood clot sticks around for a very long time, it’s kind of hard to explain to patients, especially, because the vein actually starts scarring and kind of disappearing. So we actually have to open that back up, again, using minimally invasive methods to either balloon open the blood vessel, or actually place a stent, like a metal stent.

So the last thing I’ll say also about that is if patients can’t have the blood clot removed or there is a large amount of blood clot, but can’t get any medications to dissolve it, we also place a device called IVC filters. There’s a lot of misinformation out there about these devices, but the reality is that when they’re used appropriately, they actually do help patients, and we place them when indicated to kind of help those clots from actually physically traveling from the legs to the lungs.

And then I’ll add. From a surgical perspective, we have a few options. We obviously try to stick with the minimally invasive methods, if possible, but sometimes you need a more immediate fix. And so in those circumstances, we’ll actually do a surgical procedure, either a thrombectomy or an embolectomy, where we, essentially, visualize the vein directly, and make a small incision in it to try to remove as much of that clot as possible.

With the thrombolysis, which was just described, sometimes that can take 24 to 48 hours for you to really see improvement in patients. So for some people, doing a surgical procedure is what’s necessary. When there’s large, extensive blockages, we’ll also do some venous reconstructions on patients. That’s a little bit more rare, but we can do reconstructions or bypasses around large blockages, if necessary, as well.

And I think maybe, if I could add also, I think what’s really nice and unique about our program is that we work together. We like each other, and we have we have specialists in a number of different specialties. We have vascular surgeons, we have radiologists, we have cardiologists and others that discuss this. This is a complicated issue. There’s no one size fits all solution to any of these problems. And so we often will discuss patients from a multidisciplinary standpoint, and try to figure out how we can work together to really take the best care of patients possible.

That’s fantastic. More questions coming in from viewers. So I want to get to as many as these as we can. Does losing weight to make vascular disease go away?

So maintaining a healthy weight is definitely helpful for the health of your veins. So that’s definitely easier said than done. So in most of my patients, I’m recommending a heart healthy diet. So the quick answer to that question is yes, maintaining a healthy weight can help significantly.

Perfect. Another question from a viewer. Would the pain feel like leg cramps?

It definitely can. Pain from a deep vein clot– I’m assuming that’s what the question is, is about a deep vein thrombosis– can definitely feel like leg cramps. It can feel like a heaviness, a soreness, sometimes there’s redness or tenderness of the leg, but cramping is a common complaint.

We’re getting close to the end of the time for the program, and there’s one thing I want to touch upon because I’d like for you to talk to us a little bit more about the comprehensive venous thrombosis and pulmonary embolism program. Don’t know who wants to kick that one off, but if you can just kind of–

I can take us down that one.

That would be great.

Yeah. So as I was sort of alluding to just a minute ago, we have a nice group of physicians and specialists here at the University of Chicago that help to diagnose, treat, and follow these patients with any of these conditions, and in particular, with the venous condition, such as DVT and pulmonary embolism. We have a group of physicians that will take care of patients in the hospital. I’m particularly interested in pulmonary embolism. So we have a group of physicians that are part of what we call the Pulmonary Embolism Response Team or the PERT program.

When a patient comes in with a life threatening PE or otherwise, we get together very quickly, whether it’s the middle of the night or the middle of the day. We discuss the patient. We discuss the best management for the patient. And oftentimes, we’ll come into the hospital, and take care of the patient the middle of the night. We also discuss these patients in follow up. So we’ll have patients that come into the clinic several months after they have their DVT or PE event.

We’ll discuss blood thinners. We’ll discuss IVC filter removal, if necessary. We’ll discuss genetic testing for potential underlying conditions that make folks more predisposed. This is all under the umbrella of what we call the Comprehensive Venous Program or the Comprehensive Venous Thrombosis and Pulmonary Embolism program. We all work together. It’s a great program. I think it’s a unique thing we have here at UChicago Medicine, and we’re growing every day.

Fantastic. Well, you three were fantastic.

Thank you.

Thanks for having us.

Appreciate it. That’s all the time we have for the program. Please remember to check out our Facebook page for future programs, and helpful health information. Also, if you want more information about UChicago Medicine, please take a look at our website at uchicagomedicine.org. If you need an appointment, give us a call at 888-824-0200. Thanks again for being with us today and I hope you have a great week.

Blood in the Urine

Blood in the urine (hematuria) can appear for a variety of reasons. If this happens after an injury (such as a car accident or fall), in most cases it is a sign of a bruised kidney or bladder. Common causes of blood in the urine include urinary tract infections, kidney stones, inflammation, tumors, and a variety of other kidney or bladder disorders. Blood may also appear in a urine sample during menstruation, although the blood does not come from the urinary tract.

If only a small amount of blood is present, urinalysis will show it is present, even though the color of the urine is yellow and not pink or red. This is possible with any of the conditions listed above, as well as after heavy physical activity or at high temperatures. In this case, the doctor may prescribe a second urine test on another day. It will then be seen if there is still blood in the urine.If so, other tests will be ordered to determine the cause.

Home care

Observe the following recommendations for home care:

• If there is no visual blood in the urine (urine is not pink, brown or red), you do not need to limit your activity in any way.

• If you see blood in your urine, you need to be calm and not physically exert yourself until your next doctor’s examination. Do not take aspirin, blood thinners, anti-platelet, or anti-inflammatory medicines. These drugs also include ibuprofen and naproxen. They thin the blood and can cause increased bleeding.

Follow-up

Come back for your follow-up appointment or as directed by your doctor. If you have blood in your urine after an injury, you should re-take a urine test after 1–2 days. See your doctor for this test.

If radiographs have been taken, they should be seen by a radiologist.You will be told if these results may affect your treatment.

When to seek medical attention

In the following cases, you should immediately contact your healthcare provider.

• Bright red blood or blood clots in the urine (if not previously)

• Weakness, dizziness or fainting

• Pain in the groin, abdomen or back

• Temperature 100 , 4 ° F (38 ° C) or higher, or as directed by your healthcare practitioner.

• Repeated vomiting

• Bleeding of gums and nose or frequent bruising

Thrombosis: Symptoms, Treatment, Symptoms | doc.

ua

In case of damage to blood vessels, the body must use fibrin and platelets (blood cells) to form a blood clot, the so-called thrombus, which prevents the loss of blood volumes. In cases of pathologies, blood clots form in the bloodstream even without the process of vascular damage.Clots that circulate freely throughout the entire bloodstream are called “emboli”.

If blood clots cover more than 70% of the cross-section of the lumen of the arteries, the flow of blood and oxygen to the tissues of the body decreases, as a result of which hypoxia and metabolic disorders occur – metabolic products accumulate in tissue cells. If the overlap is greater than 95%, cell death may occur due to complete oxygen deprivation.

Factors influencing the development of thrombosis

This pathology most often occurs in elderly people, but in cases where a person leads an improper lifestyle, the risk of thrombosis becomes higher.A person may be overweight, which most greatly exposes the risk of pathology. In addition, the occurrence of thrombosis is actively influenced by improper surgical techniques, smoking, some drugs that affect blood clotting, most often hormonal drugs. Also, thrombosis can occur in case of hypothermia, transfer of infections that damage the walls of blood vessels.

If the factors for the development of pathology are known, the prevention of thrombosis should also be known.So, in addition to correcting the diet (excluding foods that affect the process of weight gain), people who have undergone any surgery need to do light physical exercises that help improve physical tension in the muscles of the limbs and venous blood flow. Before or after surgery, the patient is advised to take anticoagulants that thin the blood, and the phlebologist must instruct on the correct use of golfs or socks, which have a compression effect and tighten the legs.

Symptoms

In this pathology, called “thrombosis”, the symptoms are not detected at one moment, because it develops gradually. So, in order to determine this pathology, you need to pay attention to such defects as swelling of the leg in the lower thirds, but if the thrombosis has spread to the higher parts of the legs, then the entire leg will swell completely. You may experience pain in the groin area. There is an intermittent symptom of thrombosis – pain in the muscles of the calf region, which can worsen during flexion of the ankle joints.If such pains are identified along with edema, you should immediately contact a therapist.

In addition to these, there are also symptoms such as increased sensitivity of the skin on the limbs, and the skin near the place where the thrombus is located is warmer and with a red tint, in contrast to the surrounding areas.

There are cases when thrombosis proceeds without symptoms and then, as a rule, it is detected already with the development of various complications, for example, pulmonary embolism occurs, as a result of which there is sudden shortness of breath, a feeling of inability to breathe, dizziness, and possible loss of consciousness. If you have such symptoms, you should immediately call an ambulance.

Treatment

Treatment of thrombosis always depends on the factor due to which it developed, as well as on the degree of complication and the age of the person. In normal situations, in the case of a strong attachment of a blood clot to the walls of the vessel, and when there is no danger of a clot detachment, drug therapy is prescribed. When there is a risk of tearing off a blood clot, then surgical intervention is recommended for the patient.

Types of pathology

Depending on the degree of complication and on some other factors, the following forms of the disease are distinguished:

• Vein thrombosis is a disease accompanied by the formation of blood clots in the veins, which partially or even completely block these vessels.Most often in the practice of medical workers, deep vein thrombosis of the legs was encountered, which appeared as a result of impaired blood outflow through a vein blocked by a thrombus, and due to stagnation of blood, swelling and blue skin appears in the area of ​​the blockage;
• thrombosis of the extremities, which occurs due to untimely diagnosis of the first stage of the appearance of this pathology;
• deep thrombosis is the most dangerous form, due to which the phenomenon of a floating thrombus with its successive separation can occur, which leads to massive thromboembolism, as a result of which the patient dies immediately;
• Thrombosis of the lower extremities is a phenomenon when one or more blood clots form in the limit of the deep vein of the lower extremity or pelvic region, as a result of which the vascular wall can become inflamed, the venous outflow is disturbed, a trophic disorder of the lower extremity occurs, as well as phlegmon of the thigh;

90,013 deep vein thrombosis occurs in 15-25% of the total population, and its prevalence ranges from 40 to 150 cases per 10,000 population. If there is no treatment, then 4-17% of all cases, death occurs from deep vein thrombosis. Men are more susceptible to this disease than women;

• Vascular thrombosis can only be detected by a therapist and suggest that the patient undergo annual diagnostic screening tests for thrombosis, and for its prevention, he should be advised to take magnesium, which prevents vascular thrombosis and maintains high blood fluidity.

Blood clots in blood vessels – why is this a deadly disease?

“A blood clot came off” – a mysterious phrase that leads to sad consequences.How many stars of show business, of different ages and habits, have passed away for this reason. Why does illness leave little chance of salvation? Can you warn her?

Let’s talk about this in our article: where do blood clots come from in blood vessels, what to do for prevention and how to treat.

What is a blood clot in the vessels

Thrombus is a blood clot that consists of stuck together red blood cells – platelets and fibrin protein. In normal mode, these elements of the body are responsible for blood clotting and perform useful functions: they stop bleeding.But when the vessel is damaged, a blood clot forms in this place.

Thrombus is dangerous because it prevents blood from flowing freely through the vessels. Over time, it can break off and get into the heart, lungs, brain and cut off blood circulation in vital organs. The result is heart attack, stroke, gangrene, paralysis and death.

Thrombus does not just form. Several factors are decisive: a person’s lifestyle, diseases.

Let’s talk about those who are at risk for blood clots in the vessels a little later.

How blood clots occur in blood vessels

In a healthy body, blood circulates freely between organs, delivering nutrients and oxygen. A blood clot appears when a vessel wall is damaged, for example, due to an excess of sugar in the blood. The fabric becomes rough. Platelets cling to irregularities, plaques are formed.

At this point, the vessel narrows and the blood flow rate changes. Turbulence occurs – a vortex, chaotic blood flow. Platelets and fibrins stick together to form a clot.

What does it mean “the blood clot came off”

Blood clots occur in vessels, veins, arteries or atria. After a while, the clot or part of it breaks off and is carried by the blood stream from the place of formation to the brain, lung or heart.

A torn off blood clot causes:

• pulmonary thromboembolism;

90,013 strokes;

• heart attack.

Venous thromboembolism is when a blood clot forms in the deep veins of the lower extremities and travels to the lungs.There, it blocks the vessels and blocks the flow of blood to a certain part of the organ, thereby posing a threat to human life.

In a stroke, a blood clot breaks off and is transferred to the brain by the blood. The larger the clot, the larger the area of ​​brain damage.

In a heart attack, a blood clot blocks the coronary artery and the heart does not receive oxygen.

A torn off blood clot leads to death or disability.

Who is at risk

Please note if you are:

• over 40 years old;
• are obese;
• varicose veins;
• ischemic heart disease;
• oncology;
• Lead a sedentary lifestyle;

90,013 experienced lower limb injuries;

• you often travel long distances;
• suffered a stroke, lung disease;
• are taking oral contraceptives or hormonal therapy

there is a high likelihood of a blood clot forming in the vessels.The risk of thrombosis during pregnancy increases significantly, because the mother’s body changes greatly, it starts working for two, the level of female hormones increases.

How to recognize

• swelling of the legs;
• venous meshes;
• unreasonable dry cough, or with blood;
• heart rhythm is disturbed;
• chest pain;
• redness with a change in body temperature in this place;
• fatigue.

Blood clots are dangerous because they may not show signs, so death comes suddenly and quickly, so that doctors do not have time to intervene.But if you have a predisposition, then a timely examination will help save your life.

How to treat blood clots in blood vessels

Any treatment begins with a visit to a doctor. He will prescribe a therapy regimen based on the reasons and after the examination: ultrasound of the lower extremities, ECG, coagulograms – examines the blood coagulation ability.

If you have atrial fibrillation, that is, an irregular heartbeat, your doctor will prescribe coagulants – substances that thin the blood, and cardiac aspirin, which prevents platelets from sticking together.

In the case of deep vein thrombi of the lower extremities, it is suggested to be treated with a laser or to remove the damaged veins through punctures.

Surgery under general anesthesia is not excluded if the situation is critical.

Prophylaxis in the sanatorium

To avoid the appearance of blood clots in the vessels, take time for the examination. You can go through it in the sanatorium-resort complex “Mashuk Aqua-Therm” during your vacation, combining relaxation with the health of the body. Here you will find special programs for preventing blood clots and preventing strokes and heart attacks.

We advise you to be careful about your health, undergo annual check-ups and see a doctor.

Subscribe to our blog to learn even more about how to stay healthy – methods of treatment, prevention of diseases, as well as relaxation in the Caucasian Mineral Waters.

90,000 COVID, thrombosis and thrombodynamics – Science – Kommersant

Thrombodynamics – a test for early diagnosis of disorders of the blood coagulation system, identifying the risks of bleeding and thrombus formation.The developer of the test is GemaCor Labs (a resident of Skolkovo).

At the very beginning of the COVID-19 pandemic, Chinese doctors in Wuhan noticed a violation of the blood coagulation mechanism, especially in critically ill patients. The patients had active thrombus formation, that is, the formation of blood clots in the arteries and veins. Thrombosis, as it turned out, is one of the most common complications of coronavirus infection, which often leads to the death of patients. The first patient with coronavirus who died in Russia died precisely because of bilateral pulmonary embolism.

In Russia, the first person who became interested in the problem of thrombosis in coronavirus infection was a corresponding member of the Russian Academy of Sciences, professor at Moscow State University. MV Lomonosov Fazli Ataullakhanov, who organized a study to assess the state of blood coagulation in patients diagnosed with COVID-19 in Russian clinics and attracted several dozen young doctors as volunteers, including students and employees of the Skolkovo Institute of Science and Technology (Skoltech) . .. By examining blood coagulation in various ways, it is possible to timely detect the onset of the hypercoagulability process and significant vascular thrombosis and prescribe anticoagulants (drugs that reduce blood clotting) to the patient, primarily heparin.To track the coagulation processes, Professor Ataullakhanov decided to use the innovative device for blood testing “Thrombodynamics Recorder”, developed by the HemaCor company and the Rusnano portfolio company, which allows you to accurately determine the state of hypercoagulation.

“Our method of thrombodynamics is one of the laboratory tests, but it is fundamentally different from them,” says Ilya Spiridonov, General Director of HemaKora.

clinic, blood or plasma is mixed in a test tube with various coagulation activators, and then the time during which the blood clotted is measured.But after all, in the body, blood begins to clot where there is some damage to the blood vessels, and a blood clot grows from the site of damage. That is, in a spatial sense, this is a very heterogeneous process. Our test uses a localized coagulation activator. It contains exactly the same protein that is exposed into the lumen of the vessel at the site of damage to the wall, where there is a wound. And from this place in our cuvette, a thrombus begins to grow in the same way as from the site of damage it begins to grow in a vessel.By assessing with the help of video microscopy the rate at which the clot grows, its density, maximum size and the period during which it began to grow, we can predict the patient’s tendency to thrombotic complications.

In addition, the thrombodynamics method helps to select the optimal dose of anticoagulants. If, at the moment when the effect of the drug ends, thrombodynamics is performed, it is possible to understand whether it was possible to normalize coagulation. This is especially true for critically ill patients with COVID-19.“Apparently, the coronavirus itself is very procoagulant in its action, because it inflames the vascular wall and gives a powerful activation of the coagulation system and standard doses of anticoagulants in some cases may be inadequate,” emphasizes Ilya Spiridonov.

“Thrombodynamics Registrar” was registered by Roszdravnadzor at the end of 2012 and is currently used in about 200 clinics. In 2015, sales began to Europe, in 2019 – to the United States, and recently a distribution contract was signed with one of the Asian countries.Last year, about 100 thousand test systems were delivered to Russia and abroad.

“Thrombodynamics recorder” is used to determine hypercoagulation in a variety of pathologies, and whether it will be widely used in the treatment of COVID-19, the study conducted by Professor Ataullakhanov will show. Its observation part, which was held on the basis of ten hospitals with the participation of thousands of patients with coronavirus infection, has recently ended. She showed that the method allows you to identify a group of patients who are subject to more careful observation for thrombotic events.

A second, interventional part of the study is now planned: one group of patients with coronavirus will be treated with standard doses of heparins, and for the second, the dose will be selected by the thrombodynamics method. If the method proves to be effective in selecting and adjusting the dose, the researchers hope that it will significantly reduce the number of both severe cases of COVID-19 and deaths. To carry out this stage of the study, fundraising has been opened on the Planet crowdfunding platform.

Elena Tueva

90,000 How to tell if you have a blood clot: everyone should know these symptoms of thrombosis “UDF

Illustrative photo

A blood clot is a blood clot that has changed from a liquid to a gel or semi-solid state. Clotting blood is a necessary process to prevent the loss of too much blood in the event that you are injured or cut. When a clot forms inside one of your veins, it doesn’t always dissolve on its own.This can be a very life-threatening situation.

An immobile blood clot will usually not harm you, but there is a chance it will budge and become dangerous. If a blood clot breaks off and travels through veins to the heart and lungs, it can become stuck and obstruct blood flow. This condition requires urgent medical attention.

If you think you may have a blood clot, you should contact your doctor immediately. The specialist will be able to review your symptoms and medical history and recommend what steps to take.

Types of blood clots

Your circulatory system is made up of vessels called veins and arteries that carry blood throughout your body. Blood clots can form in veins or arteries. An arterial thrombus causes symptoms immediately and requires emergency treatment. Symptoms of a clot include severe pain, paralysis of body parts, or both. It can lead to heart attack or stroke. A blood clot that forms in a vein may accumulate more slowly over time, but it can still be life-threatening.The most serious type of venous clot is deep vein thrombosis.

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) is a condition where a clot forms in one of the major veins deep inside your body. It most commonly occurs in one of the lower limbs, but it can also occur in the arms, pelvis, lungs, or even the brain. It is impossible to confirm its presence without consulting a doctor. But if you know the most common symptoms and risk factors, you can figure out when to see a specialist.

Possible blood clot without obvious symptoms. When symptoms do appear, some of them overlap with symptoms of other diseases. Below we have given the first signs and symptoms of a blood clot in the leg or arm, heart, abdomen, brain and lungs.

Blood clot in the leg or arm

Most often, a blood clot forms in the lower leg. A blood clot in a leg or arm can have a variety of symptoms, including:

swelling

pain

weakness

warm sensation

reddish discoloration

Symptoms will depend on the size of the clot.This is why there may be no signs, or you may only have a slight swelling of the calf without much pain. If the clot is large, the entire leg may swell with severe pain. Blood clots on both legs or arms are rare. Your chances of getting a blood clot are increased if your symptoms only spread to one leg or one arm.

Blood clot in the heart or heart attack

A blood clot in the heart causes a heart attack. The heart is a less common site for blood clots to form, but it can still happen.A blood clot in the heart can cause pain or a feeling of heaviness in the chest. Other potential symptoms are dizziness and shortness of breath.

Abdominal blood clot

Severe abdominal pain and swelling may be symptoms of a blood clot somewhere in the abdomen. They can also mimic food poisoning symptoms.

Blood clot in the brain or stroke
A blood clot in the brain is also known as a stroke. A blood clot in the brain can cause a sudden and severe headache, as well as several other symptoms, including sudden difficulty speaking or seeing.

Pulmonary clot or pulmonary embolism
A condition where a blood clot enters the lungs is called pulmonary embolism (PE). The symptoms of PE can be as follows:

sudden shortness of breath, not caused by exercise
chest pain
heart palpitations
breathing problems
hemoptysis
(See also: What to do if a person faints)

What are the risk factors?
Certain risk factors increase the chances of a blood clot forming.A recent hospital stay, especially if it is prolonged or associated with major surgery, increases the risk of blood clots.

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General factors that may put you at a moderate risk of blood clotting include:

age, especially if you are over 65
long trips, especially those that resulted in you sitting for more than four hours at a time,
bed rest or prolonged sedentary life
obesity
family history of blood clots
smoking
cancer
When to see a doctor?
It is very difficult to diagnose a blood clot by symptoms alone.Nearly 50 percent of people with DVT have no symptoms. This is why it is best to call your doctor if you think you have a blood clot. It’s especially worth worrying about symptoms that come out of nowhere. Call an ambulance right away if you have any of the following complaints:

sudden shortness of breath
chest pressure
difficulty breathing, seeing or speaking
The doctor will be able to determine if there is a cause for concern and will refer you for additional tests to determine the exact reason.In many cases, a non-invasive ultrasound (ultrasound) scan will be the first step. This test will show images of veins or arteries to help the doctor make a diagnosis.

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News from other media

90,000 Alarming symptoms that you have blocked arteries

Blood clots

Blood clots are jelly-like masses created by trauma in an attempt by the body to prevent excessive bleeding.

A clot in the damaged area is created by platelets and proteins in the plasma, and when the damage heals, the body dissolves the clot

Blood clots can form inside veins and arteries without injury and cause stroke or pulmonary embolism.

Stroke

Stroke is the leading cause of severe long-term disability.

• It affects over 130,000 Americans a year.
• Every 40 seconds Americans have a stroke, and every 4 minutes someone dies of a stroke.
• About 87% of all strokes are ischemic, which are characterized by blockage of blood flow to the brain.

Therefore, blood clots are a serious problem and should receive serious treatment.

When they occur in veins and arteries, they cause severe damage. The role of the arteries is to carry oxygenated blood away from the heart, and the veins are supposed to return oxygenated acid to the heart.

Arterial clots block oxygen and blood flow from reaching vital organs and are most commonly formed in the legs.When they form in the heart, they cause a heart attack, and if they form in the brain, they lead to a stroke.

Symptoms of arterial clots are: muscle pain and spasms cold hands or feet weakness in the affected area loss of color in the affected area tingling or numbness of the leg or arm

Risk factors for blood clots: obesity physical inactivity diabetes high blood pressure high cholesterol

Venous blood clots form slowly in the veins and usually develop after surgery or injury.They can be of three types: deep vein thrombosis (DVT), pulmonary embolism (PE), and superficial venous thrombosis.

The first type usually occurs in the thighs, lower legs, or pelvis, but it can also form in other areas of the body such as the liver, arms, brain, intestines, or kidneys.

PE can be fatal as it ruptures the origin and travels to the lungs. Superficial venous thrombosis forms near the surface of the skin and it really hurts.

The most common symptoms of venous clots are: Pain in the veins, hard to touch.Painful, swollen, or inflamed skin over a vein. Altered skin color over the vein.

5 symptoms

The American Society of Hematology states that a person has the following 5 symptoms due to the formation of a blood clot in a specific area:

Brain

Weakness of the face, arms or legs, dizziness, vision problems, difficulty speaking, sudden and severe headache.

Heart

Severity or pain in the chest, nausea, shortness of breath, discomfort in other areas of the upper body, sweating.

Lungs

Severe chest pain, shortness of breath, sweating, fever, coughing up blood.

Arm or leg

Sudden or gradual pain, swelling, tenderness and warmth, and loss of leg hair.

Belly

Intense abdominal pain, diarrhea, vomiting.

To prevent the formation of blood clots in the body, you should follow the advice below:

Active lifestyle

Start exercising regularly, as the adverse effects of a sedentary lifestyle are extremely harmful.

Healthy diet

You should stay away from foods rich in GMOs, sugars or artificial sweeteners, and avoid processed foods, refined carbohydrates and trans fats.

Changes in Medication Try to find healthier alternatives to hormones, blood pressure and cancer drugs as they increase the risk of blood clots.

Quit smoking Tobacco increases the risk of blood clots.

In addition, the following natural blood thinners and supplements can help you prevent blood clots:

• Vitamin C – This powerful antioxidant supports vascular health.
• Ginkgo – Reduces fibrin, a protein essential for the formation of blood clots.
• Omega-3 Fatty Acids – Increase your intake of omega-3 rich foods such as fish, pumpkin seeds and walnuts.
• Vitamin E – This vitamin protects against oxidation, so you should consume more almonds, green leafy vegetables, kiwis, avocados, broccoli and courgettes.
• Blueberries, ginger and turmeric – interfere with the ability of platelets to contract, causing a blood clot.
• Natural antibiotics. These include garlic, onion and olive oil

90,021 90,000 You need to drink more and jump less than

“Recently I read in the“ Tribune ”that with phlebothrombosis it is dangerous to massage the legs. What else cannot be done and why? Is it possible, for example, to take a steam bath? ”
V. ROZHIN, Ukhta district

As the head of the department of cardiovascular surgery of the republican cardiological center Dmitry Epifanov told us, massage with deep vein thrombosis can provoke a blood clot separation.The consequences are the most sad, up to and including death. With thrombosis of the lower extremities, thermal procedures are categorically contraindicated, even hot foot baths, not to mention the sauna and steam room.
According to Dr. Epifanov, with phlebothrombosis, the legs should be protected from bruises. After all, any injury is an internal wound. It is in the wound that a blood clot forms, which can turn into a blood clot.
In addition, people with deep veins should not jump, run, or carry heavy things.

The worst gangrene

The saphenous veins, which accumulate blood from the outer and inner surfaces of the foot, flow into the deep veins, which are located in the thickness of the muscles, close to the bones.
More than 80 (!) Percent of venous blood moves to the heart by the shortest route through deep veins – the main trunks. If a blood clot has formed in a deep vein, there is a great risk that it will come off.
In general, deep vein thrombosis is much more dangerous than diseases of the superficial and saphenous veins, even such as trophic ulcers, varicose veins, elephantiasis, erysipelas or gangrene.With gangrene, in the worst case, you can lose a limb. And with venous thrombosis – life.
Sometimes blood clots reach sizes of 30-40 centimeters. And if such a large clot gets into the heart along with the blood stream, instant death will occur.
Thrombosis often results in blockage (thromboembolism) of the branches of the pulmonary artery. Once in the heart muscle, a blood clot causes a massive heart attack, and if in the head, an ischemic stroke. These serious complications require urgent resuscitation and long-term treatment.

Side jokes

With thrombosis, doctors say, jokes are bad. Although the patients themselves often do not understand this. For example, they do not attach serious importance to the fact that when they walk, their legs begin to swell. Many people think that this is due to overstrain of the calf muscles.
Thrombosis develops when several factors coincide: contusion, inflammation, increased coagulability and slow blood flow.
For the treatment of thrombosis, doctors offer blood thinning pills (warfarin, xarelto).You can also use the more popular and familiar drugs – cardiomagnet and aspirin (0.25 mg three times a day). But we must remember that laboratory monitoring of blood viscosity is also necessary in order to exclude its sharp dilution and possible negative consequences, including hematoma. Therefore, it is necessary to regularly donate blood for analysis (INR).

Press on the tomatoes

In order for the blood to thin, it is necessary to eat appropriately. Nutritionists suggest that patients drink a lot of water, cranberry juice, tomato juice.
It is better to exclude alcoholic beverages altogether.
It happens that blood clots resolve by themselves, especially in young patients. But, according to Alla Popovskaya, a surgeon at the Syktyvkar polyclinic No. 3, in old age it is no longer worth hoping for this. As a rule, blood clots during the years of illness firmly adhere to the walls of blood vessels. Therefore, it is necessary to do everything so that they remain in their “usual” place to the end. It is necessary to exclude serious physical activity and thermal procedures, all recommendations of doctors should be followed.

There really is in the legs

Patients with thrombosis should lead a healthy lifestyle and not pump themselves up with fears about the possible separation of a thrombus.
The fact is that stress contributes to blood clots to a large extent. At the same time, patients should not forget that the legs are a single venous pool, and since the heart pumps blood through the arteries, for the veins that lift it from the lower extremities against the natural force of gravity, it is the calf muscles that serve as a real pump. It is no coincidence that doctors often call them “hearts of the periphery.”
When a person walks, he, figuratively speaking, has three hearts. The muscles of the legs, by contracting and unclenching, help to improve blood flow. And patients with thrombosis should regularly load their veins. But you need to move with a calm step, not jogging.