The term venous thromboembolism (VTE) refers to a blood clot that forms in a vein, generally in the legs, but can break loose and travel to the lungs (pulmonary embolism). This is a serious condition that requires immediate medical attention. Here are its causes, symptoms, diagnosis, treatment, and prevention methods.
Causes
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Venous thromboembolism occurs when blood clots form in the veins due to a combination of factors such as blood stasis, vessel wall injury, and hypercoagulability (Virchow's triad).
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An extended period of immobility, such as on a long flight or after surgery, can increase the risk of blood clots.
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Surgical procedures, particularly those involving the lower extremities and abdomen, can disrupt normal blood flow and increase the risk of blood clots.
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Individuals with cancer, heart failure, inflammatory bowel disease, and certain genetic or acquired blood disorders are predisposed to venous thromboembolism.
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Due to changes in blood clotting factors, hormonal contraceptives, hormone replacement therapy, and pregnancy can increase the risk of blood clots.
Symptoms
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Thrombosis in the deep veins (DVT):
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Leg swelling, pain, tenderness, or warmth.
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Skin that is red or discolored over the affected area.
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Veins visible just beneath the surface of the skin that are enlarged.
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Embolism of the lungs (PE):
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Shortness of breath that occurs suddenly.
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With deep breathing or coughing, chest pain may worsen.
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Lightheadedness, rapid heart rate, or fainting.
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Hemoptysis (coughing up blood).
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Diagnosis
A medical history review, physical examination, and diagnostic tests are typically used to diagnose venous thromboembolism:
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A medical history includes information about risk factors, symptoms, and recent medical events (such as surgery, trauma, or prolonged immobility).
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Examine the body for signs of deep vein thrombosis (tenderness, swelling, warmth) and pulmonary embolism (rapid heart rate, low blood oxygen levels).
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A blood test to measure D-dimer levels, a substance produced when a blood clot dissolves. Elevated levels may indicate a blood clot, but further testing is necessary to confirm this.
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A blood clot can be detected using imaging techniques such as ultrasound, CT scan, or MRI.
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The purpose of venography is to obtain detailed images of blood flow and to detect any blockages in a vein by injecting contrast dye into it.
Treatment
A venous thromboembolism treatment aims to reduce the risk of complications, prevent further blood clot formation, and dissolve existing clots:
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To prevent and dissolve blood clots, blood thinners (anticoagulants) such as heparin, warfarin, and direct oral anticoagulants (DOACs) are commonly prescribed.
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A thrombolytic medication can be administered intravenously in cases of severe or life-threatening blood clots to dissolve them rapidly.
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It is possible to prevent swelling and reduce the risk of recurrent blood clots by wearing compression stockings or using intermittent pneumatic compression devices.
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In rare cases where anticoagulant therapy is contraindicated or ineffective, an inferior Vena Cava (IVC) filter may be implanted to prevent blood clots from reaching the lungs.
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Certain cases of severe or recurrent venous thromboembolism may require surgical procedures such as thrombectomy (removal of blood clots) or venous stenting.
Prevention
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Getting out of bed and moving around as soon as possible after surgery or prolonged immobility helps prevent blood stasis and reduces blood clot risk.
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During periods of immobility or for individuals at high risk of blood clots, compression stockings can promote blood flow in the legs.
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Prophylactic anticoagulant therapy may be prescribed for individuals at high risk of blood clots (such as those with a history of VTE or certain medical conditions).
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By maintaining adequate hydration, blood cannot become too thick and sluggish, reducing the risk of blood clots.
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Regular physical activity and movement, especially during long flights or extended periods of sitting, reduce the risk of blood clots.
