A young patient recently came to see me after nearly losing her life to a preventable condition that she didn't even know she had.
The woman had some warning signs and known risk factors, but did not ever imagine that she was experiencing a life-threatening event. She had a blood clot in her leg, and it eventually broke off and made its way to her lungs. The woman fainted at her home; her brother connected her to an oxygen tank he serendipitously owns and rushed her to Hoag. There, an emergency room crew was able to save her life.
Many people are not so lucky. Blood clots are a leading cause of death in this country, and they can strike at any time. Clots in the coronary arteries around the heart can cause heart attacks. In the brain, they cause stroke. And blood clots that travel from the legs to the lungs are called pulmonary embolisms, and can cause sudden death.
All told, clots in the veins, in spite of being the third most common cause of vascular death after heart attacks and strokes, are under-diagnosed, and there is great variability in the standard of care in the community.
It is therefore important for people to know whether they have a family history or an increased risk for blood clots and to know the symptoms and signs of trouble.
If you experience leg pain, including night cramps, swelling or unexplained redness in the leg, seek expert medical advice. If you have a family history of blood clots or a personal or family history of first-trimester pregnancy loss, you might be at increased risk and could potentially benefit from a prophylactic dose of blood thinners.
Oral contraceptives can increase a woman's risk of developing blood clots, as can smoking, obesity and a sedentary lifestyle. You are also at a greater risk of clotting after a surgery or a traumatic injury and within the first month after having a baby.
My intention in writing this is not to start a panic, but to raise awareness. The patient I mentioned is one of many I have recently seen who range in age from 20 to 50 and had no idea that they had this problem. Two had been on the verge of possible death.
These women are overwhelmed by this sudden turn in their lives – the knowledge that they are now living with a chronic condition, their new need for blood thinners and the stark reminder of their mortality.
Thankfully, all will continue to live active, normal lives, but they will need continuous evaluation. (I tell them all that their physician has become a “friend for life.”)
Clots are typically treated with blood thinners, which have come a long way in recent years and continue to improv
e. What is not changing as rapidly, however, is the standard of care and the level of awareness. We need to increase awareness among both physicians and the public of the nature of pulmonary embolisms and deep vein thrombosis.
It is also the mutual responsibility of the patient and the physician to get the best information possible.
If you feel you need to speak to an expert, it is appropriate to ask your doctor, who can answer your questions, and he or she may refer you to a specialist if needed.
Blood clots can be deadly, but with the right information and care, they don't have to be.
– Dr. Ehab Mady is the medical director of the Hoag Medical Group and is a vascular medicine specialist. He can be reached at 949-791-3001.
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