Question

DVT

Patients with blood clots are given anticoagulants to prevent further blood clots from forming. What are the long term health effects of blood clots? What are the chances for the patient to develop another blood clot? What type of physical activity can they do and is there any dietary restrictions?

Answer 1

Venous thrombosis is a condition in which a blood clot (thrombus) forms in a vein. This clot can limit blood flow through the vein, causing swelling and pain. Most commonly, venous thrombosis occurs in the "deep veins" in the legs, thighs, or pelvis ,This is called a deep vein thrombosis, or DVT.

DVT is the most common type of venous thrombosis. However, a clot can form anywhere in the venous system. If a part or all of the blood clot in the vein breaks off from the site where it is formed, it can travel through the venous system; this is called an embolus. If the embolus lodges in the lung, it is called pulmonary embolism (PE), a serious condition that leads to over 50,000 deaths a year in the United States. In most cases, PE is caused when part of a DVT breaks off and lodges in the lung. The term "venous thromboembolism" describes both DVT and PE.

Risk of developing another clot — People being treated for venous thrombosis are at an increased risk for developing another blood clot, although this risk is significantly smaller when an anticoagulant is used. Watch for new leg pain, swelling, and/or redness; if any of these symptoms occur, call your doctor or seek medical attention as soon as possible.

Other symptoms may indicate that a clot in the leg has broken off and traveled to the lung, causing a pulmonary embolism. These may include:

●New chest pain with difficulty breathing

●A rapid heart rate and/or a feeling of passing out

Pulmonary embolism, a blood clot in your lungs, isn't the only serious complication that can result from a blood clot deep in your veins. Although many people with deep vein thrombosis (DVT) recover completely, up to 40 percent continue to experience symptoms in their arms or legs for years after their initial diagnosis.

Known collectively as post-thrombotic syndrome or post-phlebitic syndrome, symptoms can be painful and debilitating, according to the National Blood Clot Alliance.

Post-Thrombotic Syndrome Facts

Normally, small valves inside veins ensure that blood flows in the right direction and doesn't leak backwards. When clots form in veins, however, these valves can be damaged and become leaky. Damaged valves allow fluid to pool in the arms and legs.

Complicating matters, clots that do not heal completely can block blood flow from the veins back to the heart, says Jae Sung Cho, MD, division director of vascular surgery and endovascular therapy at Loyola University Medical Center in Maywood, Ill. "The residual blood clot impedes blood flow, and the valve function may be impaired," he explains. This can lead to a number of symptoms.

Post-thrombotic syndrome symptoms include:

• Pain or aching
• Leg or arm swelling
• Heaviness
• Cramping
• Redness
• Skin discoloration or dark pigmentation
• Bluish fingers or toes
• Dry skin or eczema
• Varicose veins

If a vein is completely blocked, smaller veins nearby may enlarge to help blood move past the blockage. If these smaller veins get large enough, symptoms are usually mild. However, for some people, the smaller veins that help blood bypass a blockage do not get big enough to drain all the blood that has pooled in the arms or legs. Then, symptoms worsen.

Severe post-thrombotic syndrome can lead to sores or ulcers, which can be chronic and tough to treat. These sores affect 5 to 10 percent of people with the condition.

Post-thrombotic syndrome is a lifelong condition. Symptoms may come and go over time. They also might not develop right away.

Though it's generally believed that the condition develops 5 to 10 years after DVT, a clinical review of post-thrombotic syndrome, published in the Journal of Thrombosis and Haemostasis in 2013, suggests that symptoms may plateau one to two years later. The researchers note that a third of those who develop severe post-thrombotic syndrome have symptoms that continue to worsen six years after their initial DVT diagnosis.

Exercise and Diet for DVT patient :

Many people wonder about moving around too much after a DVT, especially if standing or walking is still painful. But if your healthcare professional is encouraging you to be more active, try and walk a little more each day, as light activity may improve any symptoms you may still be feeling and even prevent post-thrombotic syndrome (chronic pain in the legs following a DVT).

Tips to make walking a daily habit

1. Buddy up!

   Walking is more fun if you have a partner. Ask a friend or family member to take a walk with you around your neighborhood or in a local park. Take it slow, especially within the first month after a DVT, and follow your healthcare professional’s instructions about wearing compression stockings.

2. Invest in comfy shoes

   Find sneakers or walking shoes that are supportive and comfortable. If you have foot issues, consider asking your healthcare professional about orthopedic inserts.

3. Dress the part

   It’s cold out? Bundle up in layers. You can always take off a heavier jacket or sweatshirt if you get too warm. For hotter climates, loose-fitting clothing in breathable cotton or sweat-wicking material will help keep you cool and comfortable.

4. Hydrate

   Bring a bottle of water with you to make sure you’re replenishing fluids as you walk.

5. Build toward your goals

   Talk to your healthcare professional and listen to your body to determine how much walking you feel is manageable, even if it’s just in 5- to 10-minute increments. You can increase your time as you start feeling better and your confidence builds. If your diet was poor before having a DVT, your healthcare professional will likely recommend making some changes to how you eat to reduce your risk of another DVT. A heart-healthy DVT diet may also help you control your weight, blood pressure, and cholesterol, all of which are factors in heart disease. Start with the following guidelines to see how simple, delicious, and fun it can be to eat well!

6. Get familiar with heart-healthy eating basics

   You may be wondering why you should eat a heart-healthy diet when DVTs don’t affect your heart. Well, to start, the American Heart Association recommends following certain diet guidelines because they can help you lower blood pressure and cholesterol, control your weight, and reduce your risk for diabetes—all of which are risk factors for diseases of the heart and blood vessels (cardiovascular disease), which include DVT.

   • Limit unhealthy fats and sodium
   • Avoid sugary and processed foods
   • Eat more fruits and vegetables
   • Choose whole grains
   • Choose low-fat protein sources
7. Understand portion size

   Did you know that meal portions have nearly doubled in the last 20 years? Thankfully, help to remember how much you should be eating is as close as your hand!

   • 3 oz. lean protein, like fish or chicken = a deck of cards
   • 1 cup fresh fruit or vegetables = a tennis ball
   • 1 serving of potatoes, rice, or pasta = an ice cream scoop
   • 1 oz. of peanut butter or cheese = your thumb

   At mealtime, it also helps to eat from a salad plate rather than a full-size dinner plate. Fill up half your plate with vegetables and divide the other half between lean protein and grains or starch.

8. Treat yourself! (Occasionally)

   Eating well doesn’t mean you can never have your favorite foods again. When you’re regularly making healthy choices, you can feel better about treating yourself when the occasion arises.

9. Plan ahead

   It’s easier to control how often and how much you eat when you plan meals and snacks ahead of time. Try making a weekly menu with what you’ll eat for breakfast, lunch, and dinner, plus a mid-morning or mid-afternoon snack.

10. Drink alcohol in moderation

    Not only can alcoholic beverages add up to more calories, too much can have negative effects on your health. Try to stick to no more than one drink per day if you’re a woman, and no more than two drinks per day if you’re a man.