Seek Diagnosis for Symptoms of Deep Vein Thrombosis
On October 29, 2010, Jessica Phillips gave birth by cesarean section to her fourth child. Her physicians knew that she had prothrombin gene mutation, which increases the risk of developing a deep vein thrombosis (a blood clot in the deep veins, typically the legs) and/or pulmonary embolism (blood clot that travels to the lungs). Because of this, she was treated with a prophylactic dose of Heparin, a blood thinner.
The day after her son's birth, Jessica's left leg was painful, visibly swollen, hot and red. An ultrasound of the leg at that time showed no deep vein thrombosis (DVT) and Jessica was discharged from the hospital, instructed to continue the low dose of Heparin.
One week after discharge, her leg still swollen, Jessica suddenly could not breathe. She was taken by ambulance to the nearest hospital where a CAT scan revealed massive bilateral pulmonary embolisms. Her left leg had two sets of veins completely clotted.
With every breath, Jessica fought for her life. She then went into shock and had right heart ventricle failure. To save her, Jessica's doctor used tissue plasminogen activator (tPA), an enzyme that can dissolve blood clots (a "clot-buster"). The tPA carried extremely high risks of internal bleeding since Jessica had just had surgery nine days prior, but fortunately this treatment was successful and Jessica is now a 34-year old proud mother of four, happy to be alive.
Doctors at the hospital where Jessica had her baby were correct when they relied strictly on the first Doppler reading for a diagnosis. However, with persistent DVT symptoms and genetic predisposition to blood clots, repeat testing may be necessary to avoid a potentially fatal complication.
"Pain and other symptoms cannot be ignored or dismissed, especially if testing doesn't confirm a DVT diagnosis," stated Dr. Suresh Vedantham, radiologist from the Washington University School of Medicine in St. Louis, MO. "We need people to listen to their bodies and push for additional testing in order to rule out this serious, life-threatening disease, especially people with a known genetic clotting disorder."
Jessica, her doctors, and all of the staff at the hospital have learned important lessons from this harrowing experience. They are now all working together to develop doctor/patient educational materials about DVT/PE. Importantly, DVT warning signs have been added to the hospital's discharge papers for new mothers. Hopefully, these and other efforts will help avoid similar scenarios in the future.
It's important to know that anyone can develop DVT. The more risk factors you have, the greater your risk. Risk factors include:
>> Recent major surgery or injury
>> Personal or family history of a clotting disorder or DVT
>> Cancer and cancer treatments
The Vascular Disease Foundation offers a simple risk assessment at vdf.org/DVTtest.
When diagnosed and treated early enough, DVT isn't always life-threatening. Risk can be reduced by:
>> Knowing your risk factors
>> Exercising regularly
>> Maintaining a healthy weight
>> Not smoking
Dr. Vedantham stresses that "talking to health care providers about preventing blood clots before any surgical procedures or hospitalizations can also help reduce the risk of DVT/PE."
The VDF encourages you to learn about the symptoms and signs of DVT/PE, talk to your healthcare provider about your risk factors, and take action to prevent DVT/PE. "Take action as if your life depends on it, because it does. I know," says Jessica Phillips.
To learn more about deep vein thrombosis and pulmonary embolism, including symptoms, risk factors, and prevention tips, visit vdf.org.