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Deep Vein Thrombosis and Pulmonary Embolism FAQs

Reviewed by Jerry R. Balentine, DO, FACEP

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Q:Where in the body does deep vein thrombosis (DVT) occur?

A:Leg(s).

The deep veins of the lower leg and thigh are the most common origin of blood clots. DVTs might cause pain or swelling but they can also be asymptomatic.

Most blood clots originate from the lower leg, thigh and pelvis. Occasionally they can come from the upper extremity or other locations.

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Q:What is the meaning of the term "embolize?"

A:When clots break loose in the vein, they are said to "embolize."

An embolus is a blood clot that has loosened from its attachment and travels via the bloodstream to another site where it blocks a blood vessel. When these blood clots break off and move through the bloodstream they can end up in an artery of the lung where they block blood flow (pulmonary embolus).

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Q:A pulmonary embolism is a blood clot that becomes lodged in the lung. True or False?

A:True.

Pulmonary emboli (PE) nearly always occur in conjunction with DVT. Because the embolus blocks an artery, which in turn prevents the exchange of oxygen into the bloodstream, PE will cause a decrease of oxygen delivered to the organs and body systems.

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Q:What causes a person to be at-risk for developing deep vein thrombosis or pulmonary embolism?

A:Many factors can increase your risk to develop a DVT.

In general anything that slows your blood flow in the legs or makes it more likely for your blood to clot will increase your risk for DVTs:
- Prolonged bed rest (such as after surgery) or sitting (traveling)
- Blood clotting disorders or cancer (some cancers increase the substances in the blood that lead to clotting)
- Birth control pills and hormonal replacement therapy can cause your blood to clot more easily
- Trauma to the lower extremity
- Family history of DVTs or PEs
- Smoking (affects blood clotting and circulation)
- Obesity (increased pressure on veins)

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Q:Pulmonary embolism (PE) can occur without deep vein thrombosis (DVT). True or False?

A:False.

PE and DVT are often seen together as one process. Although most DVTs arise in the lower extremity, they can also occur in other parts of the body. Once a DVT is suspected, quick diagnosis and therapy is important to prevent a PE.

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Q:Who is at greater risk for pulmonary embolism, men or women?

A:The risk is the same for men and women.

Although many diseases have a prevalence for a specific gender, PE is usually linked to risk factors rather than gender. One of the risk factors is being over age 60.

In addition to age, the most common risk factors for PE are: decreased activity (bed ridden or traveling), history of certain cancers, smoking, being overweight, trauma to the lower extremity or surgery of the lower extremity, previous DVT or PE, or a family history of PE or DVT.

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Q:What are sign and symptoms of DVT?

A:Sign and symptoms of DVT can include redness, warmth, tenderness and swelling.

The classic signs of a DVT are redness, warmth, and swelling of the leg. Frequently not all of the symptoms or even no symptoms are present which can make the diagnosis difficult. The wide availability of Doppler ultrasound has helped in diagnosis of DVTs.

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Q:What are signs and symptoms of pulmonary embolism?

A:Signs and symptoms of pulmonary embolism can include shortness of breath, chest pain, coughing blood.

Depending on the size and location of the pulmonary embolus, symptoms can vary. Unlike DVTs there are usually no external symptoms. The most common presenting signs and symptoms are: shortness of breath (mild or severe), chest pain (sometimes worse with taking a deep breath), fast heart beat, and cough (sometimes with blood in sputum).

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Q:What are other risks of having a pulmonary embolism?

A:Sudden death is a possible risk associated with pulmonary embolism.

A pulmonary embolus can present in many different ways. There can be mild symptoms (fast heartbeat, slight shortness of breath) or severe symptoms such as sudden death.

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Q:What is the treatment for deep venous thrombosis above the knee?

A:Anticoagulation is the treatment of choice for DVTs.

These drugs do not break up existing clots but prevent new clots and prevent existing clots from getting bigger. These drugs are available as injectable medications and pills. As the injectable medications work faster, your doctor will usually start on you on those (heparin, enoxaparin [Lovenox®]) and then switch you to a pill (warfarin [Coumadin®], rivaroxaban [Xarelto]®).

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Q:What percentage of people who have had DVT or PE are at risk for another episode?

A:Based on follow up studies with patients who had a DVT or PE, it is estimated that about 25% will have another episode.

Once you had a DVT/PE you are at risk of for another event. This risk can be decreased by anticoagulation therapy (taking a blood thinner). Unfortunately, being on a blood thinner for prolonged periods has risk factors as well. Talk to your doctor about the best approach for your individual case.

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