Epidemiology and prevention of venous thromboembolism



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How To Prevent Deep Vein Thrombosis (DVT)

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Blood Clots Are Common And Can Be Deadly, But Many Americans Don't Know Enough About The Risks

Temple Health is on a mission to raise awareness about one of the least-known and most under-diagnosed serious medical conditions – a potentially deadly one that can be prevented, if caught early.

Blood clots, which often form to control bleeding in injured blood vessels, sometimes occur in deep veins, usually in the lower leg, thigh or pelvis and occasionally in the arm. When this happens it's called deep vein thrombosis, or DVT. Sometimes a part of the clots or multiple sections break off and travel through the bloodstream to the lungs, causing a blockage called a pulmonary embolism (PE) – which can be fatal. Together, these conditions are known as Venous thromboembolism, or VTE.

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As many as 900,000 Americans suffer from blood clots and pulmonary embolisms each year, with up to 100,000 dying, according to estimates from the U.S. Centers for Disease Control and Prevention. Every six minutes, one American dies of a blood clot, which can result from inactivity, such as sitting during long-distance plane trips or lying in bed during an illness or post-surgery. Blood clots also occur spontaneously.

Though blood clots are the leading cause of preventable deaths in U.S. Hospitals and pulmonary embolism is the third most frequent cause of cardiovascular-related disease among Americans, many people do not understand these conditions. Also, Black Americans have a 30-60% higher occurrence of blood clots than white Americans, and, as with many other health disparities, researchers don't yet know why.

That is why Dr. Parth Rali, associate professor of thoracic medicine and surgery at Temple's Lewis Katz School of Medicine, and Temple Health have endorsed the Blood Clot Prevention and Treatment Act, a bill U.S. Rep. Lisa Blunt Rochester (D-Delaware) introduced last month in honor of her late husband, who died at 52 from a pulmonary embolism. The legislation is designed to raise national awareness about DVT/PE, and create more action and advocacy for its prevention. 

"It's about primary prevention and also secondary prevention," Rali said.

Once someone has had a blood clot, they are at a higher risk for developing another one, Rali said. A person who has had a spontaneous blood clot with "no other risk factors involved" has a 30% chance of developing another clot over the next 10 years, according to the National Blood Clot Alliance.

Other risk factors for developing blood clots include pregnancy, cancer, hospitalizations, obesity and older age. But blood clots can occur without any known risk factors.

"It's a disease that can affect any race, any gender, any ethnicity," Rali said.

Catching and diagnosing blood clots early is one of the most effective methods of preventing pulmonary embolisms.

The CDC's estimate of 900,000 people who suffer from VTE each year is "just the tip of the iceberg" because current electronic medical record symptoms do "not have bandwidth to capture all the adverse outcomes and track (all) the data regarding blood clots," Rali said. "If you don't know how to capture the magnitude of this problem, you can't come up with an intervention."

Another complicating factor with blood clots is that people who have them – and some may not know it – are seeing all different kinds of clinicians. A pregnant woman with a blood clot, for instance, will most likely see her obstetrician/gynecologist. Because different physicians "may not have expertise in managing a blood clot," the disease often "becomes deadly or gets underreported, under-studied, under-treated, under-optimized in routine medical care," Rali said.

To solve that problem, Temple Health has trained clinicians and health care workers across the health system to recognize signs of a blood clot. Anytime someone comes into the hospital with a blood clot, or whenever someone already in the hospital shows signs of a blood clot, a specialized response team immediately activates, Rali said.

"It's a life-changing event, once you have a blood clot," Rali said. "Your life changes forever. You're always in a constant fear of getting a second blood clot or blood-clot-related side effects."

Rochester's bill calls for a three-pronged approach:

• Increase public awareness of blood clot signs and symptoms and educate health care providers and hospitals on the signs, symptoms and treatments of blood clots by requiring the CDC to conduct a nationwide public awareness campaign.

• Establish an advisory committee to provide advice, information and recommendations to the Secretary of the Department of Health and Human Services regarding programs, policies and research to promote the diagnosis, treatment and prevention of blood clots and pulmonary embolisms.

• Improve our understanding of who and how many Americans are impacted by blood clots by requiring the CDC to conduct a study on new ways of detecting and monitoring blood clots at the national level.

Symptoms of deep vein thrombosis and pulmonary embolism

According to the Mayo Clinic deep vein thrombosis can cause these symptoms:

• Leg swelling• Leg pain, cramping or soreness that often starts in the calf• Change in skin color on the leg — such as red or purple, depending on the color of one's skin• A feeling of warmth on the affected leg

Deep vein thrombosis can occur without noticeable symptoms.

The warning signs and symptoms of a pulmonary embolism include:

• Sudden shortness of breath• Chest pain or discomfort that worsens when taking a deep breath or when coughing• Feeling lightheaded or dizzy• Fainting• Rapid pulse• Rapid breathing• Coughing up blood


Mum Shares Horrifying Photo Of 20 Killer Blood Clots Buried In Her Leg – Triggered By The Birth Of Her 9.5lb Baby

A MUM has shared a horrifying image of 20 killer blood clots found buried in her leg - triggered by childbirth.

Starla Ellis, 30, from Ohio, US, had recently given birth to a "whopping" 9lb 10.5oz baby after a gruelling labour, when she began feeling pain in her right leg.

Starla didn't think I was going to survive

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Starla didn't think I was going to surviveCredit: Kennedy Newsand Media She gave birth to her third child Amaris via emergency C-section after the baby got 'stuck'

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She gave birth to her third child Amaris via emergency C-section after the baby got 'stuck'Credit: Kennedy Newsand Media

It began in November with an ache in her lower back, which then moved to her abdomen and right leg.

"The [leg] pain was excruciating I couldn't move, and I had to almost crawl to the car to go to the hospital," she said.

Doctors said the pain was a result of one blood clot in the femoral artery in her right leg.

She was sent home with blood thinners, which didn't work for long.

"As they discharged me, I was quite concerned as I had a numbing feeling in my leg, but I just ignored this as the hospital said I was good to leave," she explained.

At first, she thought the medicine was working.

But suddenly, she started developing a fever and noticed her leg had gone "stiff".

"Complete terror was going through my head, and I thought I might lose my leg," she said.

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The mum decided to go to a different emergency department for a second opinion.

'Close to losing my life'

Scans revealed her leg was, in fact, riddled with 20 clumps, which needed to be surgically removed right away.

Disturbing photos show the bulging red clots on a piece of cloth after they were removed from her right leg.

The mum claims she thought she would die and is now urging people to be persistent with their hospital referrals to ensure they get the care they need the first time around.

"I broke down when I saw how many blood clots were in my leg as I didn't realise it was that bad," Starla said.

She added: "Seeing a photo of all the blood clots put it into perspective of how bad it was and how close it was to me losing my life.

"Not only did the photo of the 20 blood clots shock me, but it hurt my feelings that the previous doctor let me walk out of the hospital."

According to the NHS, blood clots can be very serious and must be treated quickly.

Clots that form in the veins in your legs, arms, and groin can break loose and move to other parts of your body, including your lungs.

This can lead to illness, disability and even death.

Her leg was riddled with 20 blood clots which needed to be surgically removed right away

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Her leg was riddled with 20 blood clots which needed to be surgically removed right awayCredit: Kennedy Newsand Media The mum is urging others to be persistent with doctors

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The mum is urging others to be persistent with doctorsCredit: Kennedy Newsand Media

While it remains unclear what caused the clots, the mum claims a doctor told her the blood clots could have been caused by possible C-section complications. 

Starla said her third child, Amaris, was a big baby for her petite 5ft 3inch frame.

This meant the baby got "stuck" in her vaginal canal - which led to excessive pushing before doctors decided to take her to the OR.  

He eventually arrived via an emergency C-section.

Different types of blood clot

According to Medical News Today, there are two kinds of blood clots women may experience after giving birth.

One is clots that are passed through the vagina in the days after birth, which are from the shedding of the womb's lining and the detachment of the placenta.

The second is clots that happen inside the body's veins, which are uncommon but can be life-threatening.

This may be because pregnancy raises the pressure in the veins in your legs and pelvis, making clots more likely. 

"You need to stay persistent with your doctor with your healthcare and they don't always seem to be as worried as you are," she explained.

"You know your body, and if you feel like something is wrong, you need to get it checked out.

"Follow up with your doctor as blood clots can be fatal."

Starla with her family while pregnant with her third child Amaris

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Starla with her family while pregnant with her third child AmarisCredit: Kennedy Newsand Media Amaris was a very big baby for her size

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Amaris was a very big baby for her sizeCredit: Kennedy Newsand Media

What are the symptoms of a blood clot?

There are two types of blood clots.

A blood clot in one of the large veins in someone's leg or arm is called deep vein thrombosis (DVT).

If not treated, DVT can move or break off and travel into the lungs.

A blood clot in the lung is called a pulmonary embolism (PE) - this can be deadly and requires immediate medical attention.

Symptoms of a DVT include:

  • swelling in your arm or leg
  • pain or tenderness not caused by an injury
  • skin that's warm to the touch, with swelling or pain
  • redness of the skin
  • Symptoms of PE include:

  • difficulty breathing
  • sudden, sharp chest pain that might get worse when you breathe in
  • coughing up blood
  • fast or irregular heartbeat
  • Source: NHS, CDC






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