Deep Vein Thrombosis – A silent killer

Dr Harinder Singh Bedi
Deep vein thrombosis or DVT is a blood clot forming in a deep vein – usually in the leg veins. Symptoms of DVT can include swelling, pain, and skin discoloration .Unfortunately, nearly half of DVT episodes have minimal, if any, symptoms. These “silent” afflictions are particularly worrisome as they are often missed . While DVT below the knee is unlikely to cause serious complications, clots above the knee can break off and travel up the bloodstream, resulting in a blocked blood vessel in the lung (pulmonary embolism) which can be fatal . Other consequences are damaged blood vessels leading to chronic blood pooling, swelling and pain in the leg, and dilated varicose veins .

March is DVT Awareness Month

Certain individuals are more at risk for deep-vein thrombosis than others. Those with prior DVT, obesity, stroke, cancer, pregnancy, undergoing major surgery, over the age of 65 and those who are confined to long periods of immobility via travel or bed rest are more likely to be afflicted. According to the American Medical Association, approximately 2 million people suffer from DVT each year, more than the annual amount affected by heart attack or stroke. Pulmonary embolism claims approximately 300,000 lives annually. This is more than breast cancer and AIDS combined. Even otherwise healthy passengers are at some risk if they remain immobile for long periods eg during a long flight. In fact DVT has struck Serena Williams after a short period of inactivity and David Lehmann – the Australian cricket coach . A new aetiology is prolonged driving in an automatic car where the left leg is totally immobile. The author treated a young patient recently who drove an automatic car from Chandigarh to Delhi and back without taking an appropriate break .
One of the best ways to combat DVT is through prevention. Getting 30 minutes of daily exercise, maintaining a healthy weight, avoiding smoking and avoiding long periods of inactivity are recommended. Travelers should avoid alcohol and sleeping pills, keep hydrated, move their legs when possible and wear graded compression stockings. . Patients for major surgery should be put on appropriate therapy by their surgeons.
DVT can be diagnosed by a thorough examination by a qualified doctor, a few simple blood tests and a non-invasive test called Duplex examination. Treatment entails blood thinners and use of compression stockings. In some extensive cases direct injection of strong clot busters directly into the clot (called catheter directed thrombolysis) is needed.
NBC reporter David Bloom died due to complications of DVT while covering the Iraq war . In his memory – March is designated as DVT Awareness Month.
If you have any of the following risk factors, you may be at risk for DVT:
High blood pressure
Pre-existing heart disease
Family history of stroke, aneurysm or heart disease
Diet high in saturated and/or animal fat
Overweight sedentary people
Recent major surgery
Women on oral contraceptives
Over 50 years of age
An yearly checkup, some simple tests and positive healthy lifestyle changes – as mentioned above – can help in preventing this potentially fatal condition.
(The writer is Director Cardio Vascular Sciences at the Ivy Hospital, Mohali)