Recurrent Breast Cancer

Thursday, May 9, 2013


 Blood Clots Can Kill       
Every year, six hundred thousand people in the U.S. have a leg blood clot.
Of these, one hundred thousand die.  
These clots, known as “emboli,” travel throughout the bloodstream.
Clots that occur in arms or legs are “venous thrombi.”
Those that form in the lungs are “pulmonary emboli.”

What are effects of DVTs (deep venous thrombosis)?
Lung emboli cause lung tissue death, known as “pulmonary infarction.”
Arm and leg blood clots cause swelling, tenderness, and redness.   
Approximately thirty percent of people with lung emboli die.
 Over time, leg emboli reduce blood flow, which darkens and scars the skin. This leads to painful leg ulcers that delay healing.
Pulmonary embolus is an emergency that requires hospitalization. Its symptoms include shortness of breath, irregular heartbeat, light headedness, and chest pain.
Be aware that leg muscle strain and tendon tears can mimic blood clots.

What are risk factors for leg clots?
People who sit more than six hours.
Limited mobility following surgery.
A leg bone fracture or injured vein.
Heart failure or cancer in the abdomen.
Prior blood clot or family history of blood clots.
People older than sixty with obesity, high blood pressure, and smoking.
Pregnant women and women who take estrogen. 
People with inflammatory bowel disease. 
Medical history of genetic blood clotting disorders.
How are blood clots diagnosed?
CT Scan imaging, which involves computerized chest tomography followed by pulmonary angiogram.
Leg ultrasound, to assess vein blood flow.
A “D-dimer” blood test.

How to prevent blood clots: During long car and plane rides, wear stretch stockings that cover the legs from thighs to feet.  Walking, leg exercises and stretches will decrease risk.  If possible, avoid prolonged sitting during car and air travel.
How are blood clots treated?
A blood thinner, Warfarin (Coumadin), is injected or infused for several days as soon as the clot is diagnosed. Warfarin slows the clotting process and prevents small clots from becoming larger. However, this medicine increases bleeding risk if the dose is not carefully monitored.
Infused Coumadin is gradually switched to oral medicine over two to three days.
Once the oral dose is adjusted, Coumadin is continued over four to six months.
This medicine prevents blood clot recurrence.
However, periodic blood tests are mandatory to adjust the dose and prevent uncontrolled bleeding.
Uncontrolled bleeding due to Coumadin causes forty three thousand visits to emergency rooms every year.

 Be aware. Foods rich in Vitamin K, such as broccoli, Brussels sprouts, collard greens, spinach, and kale, can reduce Coumadin’s effectiveness.

Source: Consumer Reports on Health; Volume 25, Number 3.

Questions or comments? Contact Dr. Clem at