Deep vein thrombosis difficult to diagnoseby Heather WoolwinePublic Relations If you’ve ever had surgery, you probably remember wearing those oh-so-attractive compression stockings or taking medication afterward to avoid blood clotting. And once the doctor gave you the all clear to stop wearing them, you figured you’d never have to worry about blood clots again. It seems then that you, as well as millions of other people in the U.S., believe the myth that deep vein thrombosis (DVT) can only occur in people undergoing surgical procedures. In honor of DVT Awareness Month, MUSC implemented a Deep Vein Thrombosis (DVT) Safety Zone. DVT Safety Zone is a national program designed to help reduce the risk and raise awareness of DVT. A common, but underdiagnosed medical condition, DVT affects approximately two million Americans each year. It occurs when a blood clot forms in one of the body’s large veins, usually in the lower limbs, leading to either partially or completely blocked circulation. Complications of DVT, like pulmonary embolisms (PE), are a major cause of death in the United States, killing more people than AIDS, breast cancer and highway accidents combined. Some experts believe the incidence of DVT and PE may be higher because diagnosis is difficult and often missed. Although fatal PE may be the most common preventable cause of hospital death in the United States, preventive therapy is administered to only one-third of hospitalized patients with risk factors for blood clots, according to a recent multicenter study. “Blood clots in the veins deep within the legs are more difficult to diagnose because symptoms are present in only 50 percent of patients,” said Samuel Z. Goldhaber, M.D., director of Venous Thromboembolism Research Group and Cardiac Center’s Anticoagulation Service at Brigham and Women’s Hospital, Boston; associate professor of medicine, Harvard Medical School; and co-chair of the Council for Leadership on Thrombosis Awareness and Management. “An increased awareness among health care professionals and the public regarding the risk factors and triggering events of DVT may lead to prevention and treatment of the condition.” When a clot escapes into circulation and becomes lodged in the lungs and obstructs the pulmonary artery or its branches, it can cause sudden death. PE symptoms include shortness of breath, a feeling of apprehension, rapid pulse, sweating, and/or sharp chest pain that worsens with deep breathing. Some patients cough bloody sputum, while others develop very low blood pressure and pass out. A number of serious conditions, including an evolving heart attack and pneumonia, mimic PE. Symptoms of DVT include pain, swelling, tenderness, discoloration or redness of the affected area, and skin that is warm to the touch. However, as many as half of all DVT episodes produce minimal symptoms or are completely “silent.” Because a number of other conditions, like muscle strains, skin infections, and phlebitis (inflammation of veins), display symptoms similar to DVT, the condition is best diagnosed with specific tests like venography, impedance plethysmography (IPG) and venous ultrasonography. Certain individuals carry an increased risk for developing DVT, although it can occur in almost anyone. Some risk factors include:
Effective prophylaxis and treatment options exist for both DVT and PE. Anticoagulants, or blood-thinning drugs, are commonly used to reduce the risk of and treat DVT. These agents alter the body’s normal blood-clotting process and help reduce the risk of PE. Either modulating activation of blood coagulation or preventing venous stasis achieves this prophylaxis. Use of low-molecular weight heparins (LMWH), low-dose subcutaneous heparin, oral anticoagulants, and use of compression stockings have shown positive results in reducing PE. With early treatment, patients with DVT may reduce their chances of
developing PE to less than 1 percent.
Friday, March 18, 2005
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