Deep vein thrombosis

Published by BUPA's Health Information Team
June 2003

A deep vein thrombosis (DVT) is a blood clot (thrombus) that develops in a deep vein, usually in the leg. This can happen if the vein is damaged or if the flow of blood slows down or stops. About one in 2,000 people in the UK develops a DVT each year.

Deep vein thrombosis can cause pain in the leg, and can lead to complications if it breaks off and travels in the bloodstream to the lungs.

Where do DVTs happen?

The are two types of veins in the legs: deep and superficial (see diagram, below). The deep veins pass through the centre of the leg, surrounded by the muscles. It’s here that DVTs most often develop. Less commonly DVTs occur in the deep veins of the arm or pelvis.

Who gets a DVT?

Certain factors make a DVT more likely to occur. They are more common in people aged over 40 and in people who are obese, or who have already had a DVT. Several inherited conditions make the blood more likely to clot than usual, increasing the risk. Other factors include:

• prolonged bed rest, (immobility)
• major injuries, or paralysis
• surgery, especially if it lasts more than 30 minutes, or involves the leg joints or pelvis
• cancer and its treatments, which can cause the blood to clot more easily
• long-distance travel, because of prolonged immobility. It is unclear whether or not air travel is more risky than other long journeys - for example by car or coach
• pregnancy and childbirth - related to hormone changes that make the blood clot more easily and because the fetus puts added pressure on the veins of the pelvis. There is also risk of injury to veins during delivery or a caesarean. The risk is at its highest just after childbirth
• taking a contraceptive pill that contains oestrogen. Most modern pills contain a low dose, which increases the risk by an amount that is acceptable for most women
• hormone replacement therapy (HRT). For many women, the benefits outweigh the increase in risk.
• other circulation or heart problems

Problems caused by a DVT

A DVT below the knee is unlikely to cause complications and may only need to be monitored. But when a clot forms in or above the knee, there is a risk that it will break away and travel up the vein to block a blood vessel in the lung. This is called a pulmonary embolism (PE). Depending on the size of the clot, it can be a life-threatening condition. But with appropriate treatment, it is rare for a DVT to lead to a pulmonary embolism.

A DVT can damage the valves in the vein, so that instead of flowing upwards, the blood pools in the lower leg. This is called post-thrombotic syndrome, and can result in pain, swelling, discolouration and sores on the leg.

Symptoms of a DVT

When a clot forms, it can either partially or totally block the blood flow in that vein. Symptoms of a DVT can include:

• swelling of the leg
• warmth and redness of the leg
• pain that is noticeable, or worse when standing or walking

These are not always a sign of a DVT, but anyone who experiences them should contact a doctor immediately.

Symptoms of pulmonary embolism

These include shortness of breath; chest pain which may be worsened by deep breaths; and coughing up phlegm, possibly flecked with blood.

Anyone with these symptoms should seek emergency medical treatment.

Diagnosing a DVT

If a DVT is suspected, the doctor will take a full medical history and carry out a physical examination. Tests that also may be required include:

• the clotting properties of the blood
• an ultrasound scan
• venography – using X-rays to show the flow of blood when special dye is injected into the veins.

Treating a DVT

Treatment aims to prevent:

• the clot becoming larger
• the blood clot breaking loose and travelling to the lungs
• new clots from forming
• post-thrombotic syndrome

Medicines

The most common treatment is anticoagulant (blood thinning) medicines, which reduce the blood's tendency to clot. These are usually taken for three to six months. Regular blood tests are needed to check the levels of the drug in the blood.

Anticoagulants can stop new blood clots from forming and old ones growing. They can’t dissolve existing clots. The body does this itself over time.

The anticoagulants used are heparin (given through a vein as a "drip" or injected just under the skin twice each day) or warfarin (taken as tablets). Anyone taking these medicines should avoid activities that could increase the risk of injury. This is because one of the main ways a wound heals is through clotting, and anticoagulants interfere with this process.

Less commonly, clot dissolving drugs called thrombolytics are used to dissolve a DVT. They carry a high risk of bleeding, so are only used in severe cases, where a life or limb is threatened.

Compression stockings

To relieve pain and swelling, and to prevent post-thrombotic syndrome, some doctors recommend wearing graduated compression stockings (also called TED or thrombo-embolic deterrent stockings), which are tighter at the foot than higher up the leg. These may need to be worn for several months or more.

Putting your feet up

Most people with a DVT are advised to place a cushion under their feet while resting or sleeping, so that the feet are raised higher than the hips. This helps to reduce the pressure in the veins of the calves.

Preventing a DVT around surgery

Surgery and some medical treatments can increase the risk of having a DVT. So, hospitals often do a pre-operative risk assessment for DVT, which takes into account your personal risk factors and the type of surgery you are having. Various measures can then be used to keep the risk as low as possible. These include anticoagulant medicines, compression stockings, and an intermittent compression pump. This is a mechanical device that automatically squeezes the feet and lower legs. This helps the circulation of blood from the legs in the first few days after surgery.

General preventive advice

Anyone who feels they are at high risk of developing a DVT should seek medical advice. There are measures anybody can take to help prevent a DVT:

• exercise the legs regularly – take a brisk 30-minute walk every day
• maintain a weight that's appropriate for your height
• avoid sitting or lying in bed for long periods of time without moving the legs
• women, particularly those over the age of 35, should consider the risks and benefits of taking the contraceptive pill

Preventive measures for travellers

Although the added risk of developing a DVT caused by travelling appears to be low, it can be reduced even further by exercising the legs at least once every hour during long-distance travel. This means taking regular breaks if driving, or walking up and down the aisle of a coach, train or plane.

The muscles of the lower legs (which act as a pump for the blood in the veins) can be exercised while sitting by pulling the toes towards the knees then relaxing, or by pressing the balls of the feet down while raising the heel.

Other preventive measures:

• don't take sleeping pills. These cause immobility, increasing the risk of DVT
• wear loose-fitting clothing
• keep the legs uncrossed
• keep hydrated by drinking normally (urine should be no darker than a pale yellow). Avoid alcohol to prevent dehydration
• wear graduated compression stockings (TEDs). This is particularly important for travellers who have other risk factors for DVT

Some doctors recommend taking aspirin before travelling because of its blood thinning effects. But it is not suitable for children and can have side-effects. If in doubt, seek advice from a pharmacist or doctor.

People who have one or more of the risk factors mentioned earlier should seek medical advice before travelling.

Anyone who develops swelling or pain in the leg, or breathing problems after travelling should seek medical advice urgently.

Further information

Department of Health
http://www.doh.gov.uk/blood/dvt/

 

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http://66.70.140.217/y/aluminium.html

(10) Thrombosis

A most important effect of aluminium poisoning is thrombosis—that cause of sudden death which has so greatly increased during the aluminium era. The thrombosis generally occurs in a vein, and it is peculiar that its first effect is often an attack of clotting in a leg vein. But whether or not this does occur, clotting may occur in vessels in the legs, or lungs, or heart, and if in the heart, sudden and dramatic death may follow. Does anyone think that God meant that man in his prime should suddenly be transported from this life without warning? Surely such catastrophes are due to man’s own errors, and not to God’s lack of care in the construction and functioning of the human being. I have repeatedly, by anti-aluminium measures, in patients who have already had heart thrombosis, prevented any subsequent attacks. Further, each and every case of cardiac or lung thrombosis I have seen and tested gave an aluminium reaction, and I rate thrombosis as being high up in the list of damage that aluminium can do.

Diseases Associated with Aluminium Intoxication (several more listed)

Then the limbs, which often show symptoms. The legs may feel heavy and weak; there may be aching in the calves, which may cause staggering in the gait. The legs also feel weak even when sitting.

There may be pain in the soles of the feet as if there were a nail in the shoe, but on the other hand there may be numbness and a tendency for the limbs to go to sleep, especially when the limb is pressed against something hard. Often the limbs feel heavy. There may be pain radiating down the limb and, in some cases, paralysis may be present. The knees may tremble and the gait be unsteady and there may be a feeling of general weakness, with a sensation of lack of strength. There may be pains in the back, of a stabbing nature. A feeling that a cord or string is tied around the body can be present. In some cases paralysis of one side of the body or of a limb can occur. Twitching of the head muscles is sometimes seen.

Lastly, even the dreams can be abnormal—they are often of a frightening nature, causing wakening in terror, with severe palpitation.

Such then is a list of the more common aluminium symptoms which can be present.

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http://archives.foodsafetynetwork.ca/ffnet/2002/11-2002/functional_foodnet_november_22.htm (other info here, too!)

AMERICAN HEART ASSOCIATION RECOMMENDS DHA AND EPA TO PROTECT HEART
November 21, 2002
>From a press release
COLUMBIA, Md.-- Martek Biosciences Corporation (Nasdaq: MATK) today
commented on the American Heart Association (AHA) Scientific Statement
entitled "Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and
Cardiovascular Disease," published in the November 19, 2002 edition of
Circulation: Journal of the American Heart Association.
The statement outlines the findings of a comprehensive report that examined
the cardiovascular health benefit of omega-3 fatty acids from plant and fish
sources, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid
(EPA). The report concluded that consumption of such omega-3 fatty acids,
either through diet or supplements, reduces the incidence of cardiovascular
disease. The statement refers to studies that have indicated the following
to be associated with the intake of omega-3 fatty acids:
Decreased risk of sudden death and arrhythmia.
Decreased thrombosis (blood clot).
Decreased triglyceride levels.
Decreased growth of atherosclerotic plaque.
Improved arterial health.
Lower blood pressure.
The statement concludes that omega-3 fatty acids have been shown in
epidemiological and clinical trials to reduce the incidence of heart disease
and recommends that healthy individuals eat a variety of fish (preferably
oily) at least twice a week. The statement cautioned, however, that fish
intake "must be balanced with concerns about environmental pollutants"
because some species of fish may contain significant levels of
methylmercury, polychlorinated biphenyls (PCBs), dioxins, and other
contaminants. Both the FDA and the Environmental Protection Agency have
advised that children, pregnant women, women who may become pregnant and
nursing mothers limit their intake of certain fish. In consideration of the
health risks posed by such contaminants, the authors of the statement
conclude by stating, "The availability of high-quality omega-3 fatty acid
supplements, free of contaminants, is an important prerequisite to their
extensive use."

 

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http://www.soulwellmall.com/health.html  (ALSO CONTAINS A LOT OF OTHER GOOD HEALTH INFO!)

DVT or deep vein thrombosis which leads to blood clots that can kill, can hit those who sit too long at a desk, in the car, or in a plane. Changing positions, getting up and walking around when you can will help keep the circulation going and avoid blood clots. An aspirin can also help thin the blood.

http://chealth.canoe.ca/columns.asp?columnistid=6&articleid=10946

Fidgeting may save your life

 

So why do clots form? During waking hours, our blood constantly fights Newton's downward pull of gravity. Fortunately, the normal movement of leg muscles pressing on veins keeps blood flowing. But after sitting inactive for hours, blood flow becomes sluggish and sets the stage for a potentially fatal clot.

Should a clot develop in the leg, it will most likely remain in that location and gradually dissolve. Patients may complain of pain, or swelling of the calf, and the skin may become warm, or dusky in colour.

LODGED IN ARTERY

Fifty percent of those who develop a blood clot in the leg are not even aware of its presence. But one in four clots breaks free and travels to the lungs where it becomes lodged in an artery. This is called a pulmonary embolism which cuts off the lung's blood supply, and death may result.