Blood Clot! What Does That Mean to Me?

Patients sometimes confuse a deep vein clot (otherwise known as deep vein thrombosis - or DVT) with a superficial, skin level phlebitis. To many, the word “blood clot” is a scary condition, and the stories we read about sudden death due to a blood clot that travels to the heart or lungs are alarming.

The key take-away is that DVTs are the riskier of the two conditions. That is why patients are immediately put on blood thinners when this is identified. The blood thinners are typically heparin, lovenox or Coumadin. Aspirin is an agent that targets platelets and is not very useful in treating a DVT.

A clot in deep veins can break loose and travel to the heart or lungs. If the clot is large enough, there is disruption in blood flow to these areas, which can fatal. Blood thinners stabilize the clot and prevent migration of the clot to the chest.

Blood thinners do not cause the DVT to dissolve, which leads to a second problem of longer term “post-phlebitic syndrome.” This means that the DVT can lead to permanent disruption of the fine valve structures in the veins, causing venous hypertension (elevated pressure in the lower leg veins). This, in turn, can cause leg heaviness, aching, pigmentation changes, and ulceration of the skin at the ankle.

The recent introduction of “clot busters,” medications that are placed by an IV directly into the clot, has helped mitigate the long-term consequences of some of these DVTs.

DVTs require immediate attention and serious consideration of blood thinners. In addition, the use of graded medical support hose is a big help in reducing the risk of post-phlebitic syndrome and eventual skin damage. Generally 20-30mmHg hose (also known as Class II hose) are sufficient.