Deep Vein Thrombosis

In March of 2012, the mayor of Exeter, Pennsylvania nearly died. Then 24-year-old Cassandra Coleman stopped breathing a few months after having surgery and was rushed to the hospital. Doctors weren’t sure she would make it through the night. Coleman had become one of the estimated two million Americans each year to get deep vein thrombosis, a blood clot in a major vein. Coleman had it in her leg, one of the most common locations for the condition to occur. The condition is preventable, but can be dangerous if not treated quickly. Fortunately, Coleman’s was, and she was able to resume her duties—and her life.

People who sit or lie down for long periods of time are often prone to these clots. Coleman, for example, developed it recovering from surgery, which had her in bed for an extended period. Some blood disorders can cause an excess of coagulants, the chemicals in blood that are used in clotting. Pancreatic and other cancers also cause coagulants to accumulate. People who are overweight are at risk for thrombosis. Estrogen pills, taken as birth control or hormone replacement, can lead to clotting, and pregnancy increases pressure on the legs, making clotting more likely.

As many as half of people with thrombosis have no symptoms. Coleman showed no signs until the night she woke up not breathing. However, swelling, pain, and redness are signs of thrombosis and require immediate medical attention. About 30 percent of thrombosis cases, including Coleman, develop into a pulmonary embolism, the clot reaching the lungs and heart, which is fatal in a third of all cases. Ultrasound and other forms of diagnostic imaging are used to find internal blood clots, though ultrasound is not always accurate below the knees.

Blood thinners are often prescribed to people with a risk of thrombosis, but these medications don’t break up clots that have already formed, though they do keep those clots from expanding. Once a clot forms, treatment focuses on preventing it from getting to the lungs, such as with a filter in an abdominal vein, or breaking it up with intravenous drugs called thrombolytics. Breaking it up, however, is dangerous and only done when absolutely necessary.

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