Blood clots in the leg, called deep venous thromboses
(DVTs), can occur in a very broad spectrum of the
population. Diabetics, the elderly and those who recently
had surgery are not the only people who are at risk of
developing a blood clot. Did you know if you travel by
plane frequently, are on birth control or have cancer, you
are at risk of getting a blood clot? These are just a few
of the risk factors associated with this potentially deadly
condition. Risk factors are inherited, acquired or highly
associated. The following is a listing of those factors.
Inherited Blood Disorders: Genetic thrombophilias or an
inherited tendency to develop blood clots are rare but can
and do occur. Genetic clotting disorders are reported to
exist in 20 to 30 percent of those with blood clots1. Most
patients and their family members only discover the
condition after genetic testing for blood clot disorders is
performed on a person immediately after developing a blood
clot. It is important for the entire family to know about
the disorder, so they can get tested and prevent it from
happening to them. For those who are found to have the
disorder, simple changes in lifestyle discussed below can
prevent them from developing a blood clot.
Acquired Risk Factors: Many, but not all, of these risks
factors are avoidable and are due to unhealthy lifestyle
choices. The following factors are associated with an
increased risk of developing blood clots:
1) Obesity: Those who are overweight or obese are not only
prone to having diabetes, heart disease and high blood
pressure, but they are also at risk for blood clots. Blood
clots are more frequent in overweight people especially
after surgery, bed rest or immobilization as it is harder
for the valves in the deep veins to push blood up against
gravity due to the extra weight.
2) Immobilization: Those who are in an above or below knee
cast or splint and/or are non-weight bearing after an
injury or surgery especially those involving the lower
extremities are also at risk as the weakened leg muscles
are not helping to push the blood in the veins up to the
heart.
3) Over 40 years of age
4) Sedentary lifestyle
5) Prolonged bed rest
6) Long hospital stay
7) Prolonged air plane rides
8 Heart & lung failure
9) Varicose veins
10)Birth control pills
11)Estrogen therapy
12)Cigarette smoking
13)Pregnancy
14)Diabetes
15)High cholesterol
Highly Associated Risk Factors:
1) Previous history of blood clots
2) Cancer
3) Positive family history of blood clots
If so many people are at risk of getting a blood clot, how
do you prevent it from happening to you? The best form of
prevention are simple lifestyle modifications such as
maintaining a healthy weight, exercising, quitting smoking,
and maintaining an active lifestyle. These modifications
not only help reduce the risk of developing heart disease,
high cholesterol, high blood pressure and diabetes but they
can also reduce the risk of getting a blood clot. As a
general rule, if you have 2 or more of these risk factors,
it is important to take precautionary measures especially
if you just had surgery or are off your feet for a
prolonged period of time. Support stockings and
compression devices are widely available not only in the
hospital but in your local pharmacy and drug store to
prevent blood clots. Your doctor will start you on a blood
thinner if you are of high risk even if you do not have a
blood clot. For those with an inherited blood disorder and
those with a history of blood clots in the past, it is
especially important to take preventive measures. If you
are on a long plane ride, one can reduce the chance of
getting a blood clot by not crossing your legs while
sitting, getting up to go to the bathroom, walking around
the aircraft periodically, and by wearing support
stockings. Calf pain and swelling, increased warmth, girth,
and redness in the calf and/or a firm mass in the calf, are
all potential symptoms of a blood clot. Also shortness of
breath, chest pain, coughing, coughing up blood, increased
breathing and heart rate and fever are also signs of a
blood clot that traveled to the lung called a pulmonary
embolism (PE). Blood clots in the leg can dislodge and
travel through the bloodstream to the lung to become a PE,
stop oxygen from getting into the blood, cause shock and
even sudden death. If you experience any of these
symptoms, it is imperative that you seek medical treatment
immediately. Go to your podiatric or orthopedic surgeon,
primary care physician or other treating physician or, if
after hours, go to the emergency room immediately for
evaluation, diagnosis and treatment. If diagnosed, usually
by venous ultrasound, treatment of blood clots consists of
blood thinners to dissolve the clot.
1Murin, S., Marelich, G.P., Arroliga, A.C., Matthay, R.A.
Hereditary thrombophilia and venous thromboembolism. Am J
Respir Crit Care Med. 158:1369-1373, 1998.
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