Blood clot, venous ones, can cause chronic disability, even death. Long term diseases such as heart and lung conditions or diabetes increases your risks. Here’s what to watch out for.
Each year one in a thousand of us develops deep vein thrombosis (DVT) in the calf (around one in a 100 people over the age of 80 years). More than one in 10 go on to have a pulmonary embolus (PE) part of the blood clot travels and blocks lung arteries, which can be fatal. More rarely, thrombosis can affect veins in the brain and other areas. Venous thromboembolism (VTE) causes around 25,000 in-hospital blood clot deaths a year. Many are preventable.
The Causes of Blood Clots
VTE is often due to a combination of risk factors. Many people have abnormal inherited blood proteins (thrombophilias) and a genetic tendency to blood clots, including Hughes/antiphospholipid syndrome, which is also linked to recurrent miscarriage.
Other risk factors include blood vessel damage (such as severe varicose veins, injury or diseases that cause inflammation) cancer and heart or lung disease.
The risk of blood clots also rises with age, or while taking the oral contraceptive pill and oral hormone replacement therapy (but not patches). Pregnancy also increases VTE risks, especially if we’re obese.
Immobility is a major factor, including at home, on flights and in hospital, particularly after major operations (such as hip/knee replacements) or if we’re dehydrated. Hospitals now use special VTE prevention stockings/boots and heparin (anti-clotting) injections in line with National Institutes for Health and Care recommendations.
Symptoms, Tests and Treatment
A blocked vein produces pain, swelling, warmth and redness in surrounding tissues, although DVT and even PE (pulmonary embolism) symptoms may be mild or unnoticed. PE can cause sudden breathlessness, chest pain (usually sharp, during breathing) and bloodstained sputum or even death.
You may need blood tests, a calf ultrasound scan and/or venogram (X-ray using dye), a chest-X-ray, heart tests and/or lung scans.
For blood clots you’ll be prescribed heparin injections, then anti-coagulant tablets for at least three months or even life-long, depending on the cause, plus advice on prevention.
Compression stockings can reduce long-term complications such as leg swelling and ulcers. Recurrent PEs are sometimes prevented with vein filters. You may also need tests and treatment for the underlying cause.
Doctors refer all patients with suspected ‘mini-strokes’ (TIA/transient ischaemic attacks) for a specialist opinion within 24 hours, which say aspirin should also be prescribed immediately. TIAs are temporary, but if facial drooping, slurred speech or arm/leg weakness last more than a few minutes, dial emergency services in case it’s a full stroke.
Ways to Reduce Your Risk
- Regular exercise. If this is difficult, get up and move around as often as you can and do calf exercises several times a day.
- Losing weight and not smoking helps varicose veins and blood flow.
- Avoid dehydration by drinking enough water and not too much alcohol to replace fluids lost by excessive sweating or vomitting/diarrhoea.
- On a flight, do calf exercises and get up and move around. Wear properly fitting flight socks/stockings.
- Seek medical advice about additional prevention measures if you have had a previous VTE, or have known risk factors.
E343 – Blood Clot Focus and Spot – www.diabetic.today