Dr Hilary Jones on Thrombosis
But did you you know this seven important facts about thrombosis?
1) Sitting at a desk, in a car, or a train for just a 90 minute period of time can reduce blood flow behind the knee by 50%, increasing the risk of thrombosis – a blood clot
2) Other risk factors: Major surgery, such as orthopaedic or surgery for cancer, or extended time in the hospital, heart diseases, pregnancy, smoking, hormone therapy, being overweight/obesity, dehydration, family history and cancer
3) Deep vein thrombosis (a blood clot in the leg) or a pulmonary embolism (a blood clot in the lung) kills one person every 37 seconds in the western world (1,2) – in England more than one in 1,000 adults could be affected by blood clots every year (3)
4) Blood clots can also travel to the brain causing strokes. These types of clots occur in people who have atrial fibrillation (an irregular heartbeat) – a condition which affects over one million people in England (4)
5) New data reveals that 75% of people in the UK wouldn’t know what to expect if they experienced a blood clot in the lungs (5) – highlighting the need to raise awareness of the signs and symptoms of thrombosis
6) itting at a desk, in a car, or a train for just a 90 minute period of time can increase the risk of thrombosis – a blood clot
7) There are a number of effective treatment options available to treat and prevent blood clots
The interview was conducted bu Antonia Lipinski on behalf of PatientTalk.Org.
Lipinski So what actually is DVT and why is it so dangerous?
DR JONES Well DVT stands for Deep Vein Thrombosis. This means that a blood clot forms in the veins which lie deep in the tissues of the body and this particularly affects the calf muscle veins. When people complain of pain and tenderness in the calf with swelling and redness it could be that they’ve got Deep Vein Thrombosis. The significance of Deep Vein Thrombosis is this that it is a very common disorder and it can have far reaching consequences. If a piece of the blood clot should break off into the circulation and be carried onwards towards the heart and lungs its means its can cause a pulmonary embolism. That is part of a clot that has broken off and has lodged in the lungs obstructing the oxygenising of blood and that can have very serious consequences and leads to a fair number of deaths every year.
Lipinski Who can get it?
DR JONES Well all most anybody can suffer from deep vein thrombosis. We know that it is more common with age but a young person who has had an injury, somebody who is having surgery, somebody is pregnant and somebody with a family history or a previous history of blood clots because some people have a genetic predisposition towards forming clots in the blood. All of these people, people who smoke even are more prone to blood clots so nobody is immune from blood clots and every 37 seconds one person in the Western world dies from a blood clot so that’s how significant it is.
Lipinski How is it treated?
DR JONES Well we know that we can to some extent we can prevent blood clots in people before it has actually happened. For example if somebody is having surgery we use compression stockings to increase the blood flow through the veins and prevent the stasis which occurs during the operation but more often then not somebody who has a deep vein thrombosis or pulmonary embolism we prevent further occurrences. We treat them. We anti coagulate them. PATIENTTALK.ORG Do flight socks actually work?
DR JONES Yes if they are up to the back of the knee and they are compressing the veins significantly. When someone is on a long haul flight, just as any kind of inactivity would do, it increases the blood flow through the veins and prevents the risk of blood clots so they really do help just as they do in a hospital setting or in anyone who is inactive and immobile for several hours at a time.
Lipinski How is PE different from DVT?
DR JONES Well a pulmonary embolism is where the blood clot breaks off from the leg and is carried up towards the lungs and blocks an artery which the feeds the lung with blood that is ready to be oxygenated. So somebody with a pulmonary embolism will be short of breath. They’ll have chest pain. They’ll have an increased heart rate. They might even cough up some blood and feel light headed. Also they might have no symptoms at all in the early stage as my brother didn’t when he had multiple pulmonary embolisms. Now he is a fit guy. He is an oarsman who rows to a very high standard and he had an abnormal collection of blood vessels in his thigh which he didn’t know about and he wondered why he was a bit more breathless when he was ain a rowing race. He saw a friend who happened to be a cardiologist who recognised the signs straight away. He was treated successfully and those abnormal blood vessels were removed. As I say anyone can be affected and the pulmonary embolism is much more serious because in many cases it can prove fatal if not treated quickly.
Lipinski What lifestyle changes can we make to prevent DVT?
DR JONES I think the first thing is to stop smoking because this thickens the blood and makes it stickier so blood clots are more likely to form. So giving up smoking is a really good step forward. Losing weight or normalising weight so you are not carrying too much weight is good. Reporting any kind of injury around the calf muscle particularly is important. Exercising on a regular basis because when you are using your leg muscles they are pumping and compressing in a rhythmically way the blood vessels underneath the muscle so the muscle pump is a good way of preventing blood clots and improving blood flow. So exercise, giving up smoking and just taking care of yourself are all important, normalising weight, these are all important. Probably nothing more so then recognising the signs and symptoms of DVT. It would be pain and tenderness in the calf, swelling of the ankle and foot, redness in this area, dilution of the surface veins so the veins look more prominent and an increased warmth compared to the other side. It always a good to compare the affected leg to the other side and if you have any doubts at all go and see your doctor and say could this be a DVT.
Further regional statistics on people diagnosed with DVT and PE in England 2010/11 can be found at: http://www.hscic.gov.uk/hes
References
1. Cohen AT et al. Thromb Haemost. 2007; 98 (4):756-764;
2. Roger VL et al. Circulation. 2012; 125(1):e2-e220
3. From prevention to treatment; taking the pulse of NHS services. Bayer HealthCare. November 2013
4. AF Association, A Guide to AF within the Cardiovascular Disease Outcomes Strategy. December 2013
5. Data on file Bayer HealthCare. Global online survey conducted in over 20,000 adults aged 18-64 between 17th July-11th August 2014. UK sample size 1,000 adults
6. International Society on Thrombosis and Haemostasis. World Thrombosis Day. Available at: http://www.worldthrombosisday.org/ Last accessed October 2014
7. Patient UK. Deep vein thrombosis. Available at: http://www.patient.co.uk/health/deep-vein-thrombosis-leaflet Last accessed October 2014
8. Turpie AGG et al. BMJ. 2002; 325: 887-890
9. NHS Choices. Causes of deep vein thrombosis. Available at: http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Causes.aspx Last accessed October 2014
10. Mayo Clinic. Deep vein thrombosis. Available at: http://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/basics/symptoms/con-20031922 Last accessed October 2014
11. Life Blood, the Thrombosis Charity. Reducing the Risk of Thrombosis. http://www.thrombosis-charity.org.uk/perch/resources/1399925355-reducing-the-risk-of-e-thrombosis-crystalmark-feb-2013.pdf