Several weeks ago, it was announced that Vice President Dick Cheney had developed a blood clot in his leg. The media blamed the clot on several factors including long plane trips over the previous week. He is the most recent in a number of public figures to have experienced this problem. Are you at risk? Moreover, how would you know if you had a blood clot?
The development of a blood clot in the leg, also called a deep vein thrombosis (DVT), can occur in anyone. A DVT is similar to a clogged drain. It can completely block off a vein or can cause only a partial blockage. The clot is made up of blood components which clump together resulting in the blockage.
Typically, a person with a DVT will complain of swelling of the back part of the lower leg. Often people will notice that one leg has become more swollen than the other has. When touching the leg, it may feel warm and tender. Bending the foot may increase the pain in the back of the leg. Performing either an ultrasound or a cat scan of the leg can help in making a definitive diagnosis.
Three factors increase a person’s chance of developing one. The first is immobility. A very common example of immobility is long car rides or airplane trips, where a person is sitting in one place for a long time. This can increase the risk of developing a DVT.
The second factor is damage to the inside of the blood vessel wall that makes it more sticky and likely to cause a clot. And the third factor? There are certain medical conditions that make a person hypercoagulable, either by having thicker blood or overly active clotting components. Many types of cancer cause this problem.
The standard treatment for a DVT is blood thinners. The most common blood thinner taken in pill form is coumadin. A disadvantage of being on coumadin is the need for frequent blood checks. Unlike many other medications, coumadin thins each individual’s blood to a different degree and it may take a while for your physician to find the right dose for you.
In addition, many foods and other medications can interact negatively with coumadin making the blood too thin. Even with all of these problems, there is no better alternative pill at this time. In certain situations, if a person cannot take blood thinners, a filter (which looks like an upside down umbrella) can be placed into the vein to make sure that the clot does not move.
One of the major concerns with DVTs is that the clot can break off and move through the blood vessels. Its route would take it through the right side of the heart into the lungs. Known as a pulmonary embolism, a person can develop shortness of breath as well as chest pain.
If it is only a small clot, a person can again simply be treated with blood thinners. If the blood clot in the lung is large, it may be necessary to use “clot buster” medications or even surgery.
Quick identification of a DVT and a pulmonary embolism is important. If you or anyone you know experiences new swelling and pain at the back of one of the legs, make sure to see your physician.
Lawrence Phillips, M.D. is a second year Cardiology fellow at Long Island Jewish Medical Center and North Shore University Hospital. The statements presented here are for information only and do not replace speaking to your own physician.
