Published in the Lynn Haven Ledger, March 2011
March Ushers in DVT Awareness Article by: Bud Shuler, MD, FACS
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arch ushers in DVT awareness month, a chance to learn more about a devastating, sleepy killer. A DVT, or deep vein thrombosis, is a blood clot that typically forms in the veins of the legs or pelvis blocking the return of blood flow to the heart. This often leads to painful swelling of the affected leg. Occasionally, they will break lose and end up in your lungs. This is known as a pulmonary embolism, or PE. When this occurs, you could die. According to “The Surgeon General’s Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism 2008”, DVT’s occur in about 500,000 Americans per year with at least 100,000 people dying either directly or indirectly from the event. Yes, as many as 1 in 3 people with a blood clot in their leg or clot in their lungs die each year. Unfortunately, it is more common in our rapidly growing and aging population. A useful concept of the etiology of the disease is attributed to Rudolf Virchow, a German physician, who in 1856 described factors that lead to clotting of blood in a vessel. Defined as Virchow’s Triad in the 1950’s it includes:
• Hypercoagulopathy (blood that is more likely to clot) • Stasis (blood that is not moving through a vessel like it should) • Damaged lining of the wall of the blood vessel Understanding this helps outline the risk factors that can lead to DVT and PE, and aid in its prevention. Although hypercoagulopathy can be an inherited disorder, it is commonly found in people with active cancer, on birth control pills, and in smokers. Stasis is the cause of the often described “economy-class syndrome” in which travelers develop blood clots from sitting in confined airline (or automobile) seats, unable to move their legs. The heart pumps the blood to the legs but the body relies on the calf muscles to help pump the blood back to the heart. If you don’t use your calf muscles, your blood pools in your calves, causing swelling, and potentially a clot. Often stasis is attributed to medical conditions such as post partum, hip and knee surgery, and stroke or bedridden patients; but stasis is also found in people who sit at a desk or computer or in front of the TV all day. In addition, severe congestive heart failure is a common factor contributing to DVT while in the hospital. Lastly, the damage to the walls of the veins occurs as a result of trauma, prior DVT’s, varicose veins, and smoking. Even though this is not a common occurrence for your every day person, there are steps that you can take to further minimize the risk. First, if you have a family history of blood clots, talk to your medical provider. If you have inherited a clotting problem or have cancer, your provider may recommend medication to help lower your risk of clots. An aspirin a day has not been shown to significantly alter the development of blood clots in veins, but may be reasonable if your provider feels you have other risk factors. Another great way to keep your blood thin is to stay hydrated.
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