Prevent, protect, inform - be thrombosis aware

For many, the initials PE symbolise standing sopping wet on a muddy playing field trying to play a typical English sport involving a ball. But PE also stands for Pulmonary Embolism, where a blood clot breaks loose from where it has been formed in the body and travels to the lungs. This is a serious condition that can prove fatal.

PE together with Deep Vein Thrombosis (DVT) where blood clots in a deep vein (most often the leg), are known as venous thromboembolism - VTE. In the US and Europe, VTE-related events kill more people than AIDS, breast cancer, prostate cancer and motor vehicle crashes combined. Every year DVT affects around 1 person in every 1,000 in the UK.

All forms of Thrombosis involve the formation of potentially deadly blood clots, either in the artery (arterial thrombosis) or vein (venous thrombosis). Blood clots in the arteries can result in heart attacks and strokes. Blood clots in the veins can cause death by blocking the blood supply to the lungs.

VTE can affect anyone regardless of age, gender, race or ethnicity and it’s vital that the signs and symptoms are known so that prompt action can be taken.

Though in some cases there are no obvious symptoms in general indicators of DVT include:

• Pain, swelling, and tenderness usually in one leg (or arm), particularly in the calf area and at the back of the knee
• A heavy ache in the affected area
• Reddish / blue skin discoloration
• Skin is warm to touch in the area of the clot

Sometimes the symptoms of a blood clot may feel similar to a pulled muscle and the pain may be worse when you bend your foot upward towards your knee. DVT usually, though not always, affects only one leg (or arm).

If left untreated, about 1 in 10 people with a DVT will then develop a pulmonary embolism. This is a serious condition that can result in collapse. Symptoms include:

• Sudden shortness of breath
• Chest pain-sharp, stabbing; that may get worse with deep breaths
• A rapid heart rate
• Unexplained cough, sometimes with blood-streaked mucus

If you experience these types of symptoms you should seek medical advice urgently.

Many blood clots can be prevented and keeping mobile and well hydrated is important. It is important to realise that anyone can develop DVT, but it becomes more common over the age of 40. As well as age, there are also a number of other risk factors including:

• being overweight or obese
• a sedentary lifestyle or being inactive for long periods such as after an operation or during a long journey
• smoking
• not drinking enough water to prevent dehydration
• having a family history of blood clots
• blood vessel damage
• being pregnant
• having certain conditions or treatments that cause your blood to clot more easily than normal – such as cancer (including chemotherapy and radiotherapy treatment), heart and lung disease, thrombophilia and Hughes syndrome
• long haul flights
• undergoing major surgery

It should also be noted that the combined contraceptive pill and hormone replacement therapy (HRT) both contain the female hormone oestrogen which increases the blood's capability to clot. This thus increases the risk of DVT. Some people may have more unusual or complex health problems that put them at risk of developing clots.

If you are having an operation at Spire Dunedin hospital, it is important you discuss any of the issues described above with your consultant or the pre-op assessment nursing team. Both will assess you for all risk factors. Your risk of bleeding will also be assessed as medicines that prevent VTE or blood clots can increase the risk of bleeding. You may be prescribed medication post-operatively to prevent VTE if your risk is assessed as high.

The medical team at Spire Dunedin will come up with the best prevention approach for you as an individual. We can’t prevent all cases of VTE or blood clots at the moment, but by working together we can reduce your risk.