Venous thromboembolism (VTE) is killing people

Health

Permit me a space in your dedicated weekly column to ask about Venous thromboembolism (VTE) which is killing a lot of people in our society. What are the risks and preventive measures?

Benedict C.

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Thanks Benedict for your question. Venous thromboembolism (VTE) occurs when a blood clot, or thrombi, forms in a deep vein. VTE describes two separate, but often related conditions:  deep vein thrombosis (DVT) and pulmonary embolism (PE).

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Deep vein thrombosis (DVT) commonly causes blood clots to develop in the lower legs or thighs. It can also impact veins in the pelvis, arms, mesentery (lining of the abdominal cavity) and brain. PE occurs when a piece of a deep vein clot breaks off, travels through the bloodstream, and becomes stuck in a blood vessel in the lungs.

What are the risk factors?

Venous thromboembolism can occur in anyone, regardless of age, gender, ethnicity, or race. Certain factors can increase your risk for developing this condition, including, medical conditions and procedures and education and lifestyle habits.

The leading risk factor for Venous thromboembolism (VTE) is long-term hospitalization. Approximately 60 percent of all VTE cases develop within 90 days of hospitalization. The most common types of surgery associated with VTE are orthopaedic surgeries, especially knee and hip replacement.

Additional risk factors for Venous thromboembolism

• Major surgery.

• Injuries that cause vein trauma, like fractures, muscle damage, long-bone breaks, and spinal cord injuries.

• Illnesses that lead to extended periods of bed rest and decreased mobility, like pneumonia and cancer.

• Obesity (people who are obese are two times more likely to develop VTE than people who are not obese).

• Age (the risk of Venous thromboembolism, begins to increase after the age of 40, and doubles with each decade beyond 40).

• Genetic conditions that cause abnormal blood clotting and blood vessel trauma

• Neurological conditions that impact mobility, like Parkinson’s disease and multiple sclerosis.

• Travel that requires long periods of sitting.

• Chronic heart and lung conditions, like congestive heart failure and obstructive pulmonary disease

• Conditions that cause chronic inflammation, like arthritis and irritable bowel syndrome

• High blood pressure

• Metabolic conditions, like diabetes  and extended exposure to air pollution

Moderate risk factors for Venous thromboembolism

• A family history of VTE, especially in immediate family members like parents and siblings

• Sitting for a long time, especially with your legs crossed

• Estrogen-based medications, like hormone replacement therapy and oral contraceptives

• Chemotherapy or radiation therapy and  lack of physical activity

• Smoking and  excessive, long-term alcohol consumption

Symptoms Deep vein thrombosis (DVT)

• Swelling, especially in the foot, ankle, hands, or wrists

• Pain and soreness, often beginning in the calf, thigh, or forearm

• Warmth in the affected area and redness or discoloration of the affected area

Symptoms of pulmonary embolism (PE )

• Chest pain that may worsen with deep breathing and rapid breath and heart rate

• Unexplained difficulty breathing, usually shortness of breath or shallow breathing

• Feeling lightheaded or dizzy and loss of consciousness

Common medical preventative measures

• Anticoagulants, which are blood thinning medications and  compression socks, stockings, wraps, or braces

• Intermittent pneumatic compression devices and rapid inflation venous foot pumps

Common lifestyle tips for preventing Venous thromboembolism

• Avoid sitting or being inactive for long periods of time.

• Increase physical activity or exercise.

• If you’re inactive, do leg, foot, arm, and hand stretches as soon and often as possible, especially during hospitalization, bed rest, or other periods of immobility.

• Stop or avoid excessive or long-term alcohol consumption.

• Stop smoking and wear loose fitting clothes.

If DVT is diagnosed, additional preventive measures may be taken to reduce your risk for PE. In some cases, the deep vein clot may need to be surgically removed. A piece of mesh may also be sewn into the body’s largest vein, the inferior vena cava, to act as a filter. The mesh can be used to trap pieces of clots and prevent them from reaching the lungs.

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