Clotting in leg going into lungs can be deadly
The incidence of spontaneous developement of clot formation in leg muscles called as Deep Vein Thrombosis (DVT) and then migrating to lungs is called as Pulmonary Embolism (PE), is not uncommon and stands out as 1 in 1000. Though anyone can develope this condition there are certain risk factors associated. The risk factors are immobility caused by trauma, surgery, increasing age or even prolonged journey, obesity, pregnancy, cancer or hormones like oral contraceptives. Thrombosis can be potentially fatal. PE is said to be cause in up to 30% of sudden unexplained deaths.
This condition can present either as swelling and pain in the muscles of the legs. The diagnosis at this stage isn’t doppler scan or rarely angiography. In case of thrombosis going into lungs a person can feel breathless or get collapsed. The diagnosis in this case is by CT angio.
Thrombosis is generally caused due to stagnation of blood in the leg muscles causing clots or when blood clots abnormally. So one has to prevent prolonged immobilisation like sitting in flight over long periods. More than 4 hours of journey doubles the risk of thrombosis, also called as economic travel syndrome though it can also happen in car or train journey.
So the prophylaxis for this condition in journey is having regular walks and stretches along with keeping self well hydrated by drinking lots of water and avoiding alcoholic drinks.
As this condition mainly affects after surgery it is very important to start early mobilisation to prevent thrombosis. Now a days patient specially those with cancer or with fractures or undergoing joint replacements in hospital are put on calf pumps to prevent clotting of the blood in leg muscles while they are in the bed. More and more techniques are used which ensure early mobilisation of the patients. Doctors also prescribe blood thinner swherever needed to prevent same. The treatment with blood thinners is generally given under close watch.
One should be very particular about checking on a hospitalised patient if thrombosis prevention is being implemented. A good understanding and avoiding the risk factors for this potentially fatal condition can go long way in improving the clinical outcomes.
Dr Gaurav Bhardwaj
MS ( Ortho), MCh ( Liverpool), FRCS (Orth) UK
MRCS ( Edinburgh), AFRCS (Ireland)
Chief – Arhtroscopy & Knee and Hip Replacement
Deptt. Of Orthopaedics.