DVT (Deep Vein Thrombosis) and Pulmonary Embolism (PE) Quiz

Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein in the leg or arm. There are two types of veins in the leg: superficial veins which lie just below the skin and can be seen on the surface, and deep veins which lie deep within the leg muscles. Clots usually form in the lower leg, thigh, or pelvis, but they can also form in the arm.

If a blood clot were to "embolize," this means the clot has broken loose and traveled through the circulatory system where it has blocked another blood vessel.

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.

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)

Pulmonary embolism (PE) and deep vein thrombosis (DVT) usually occur as part of the same process. While most DVTs happen in the legs, they can also occur in other parts of the body such as the arms or abdomen. If a DVT is suspected, it is important to have a quick diagnosis and treatment to prevent PE.

Although many diseases are prevalent in 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 (being bed-ridden or traveling), history of certain cancers, smoking, being overweight, trauma to the lower extremities or surgery of a lower extremity, abdominal or pelvic surgery, varicose veins, previous DVT or PE, or a family history of PE or DVT.

Half of people with DVT will experience no symptoms. When people do experience signs and symptoms of DVT they often include redness, warmth, tenderness, and swelling in the affected part of the body. See a doctor immediately if you experience any symptoms of DVT.

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 to severe), chest pain (sometimes worse with taking a deep breath), fast heart beat, and cough (sometimes with blood in sputum).

A pulmonary embolus can present in many different ways. There can be mild symptoms (fast heart beat, slight shortness of breath) or severe symptoms that can lead to sudden death.

Medications for deep venous thrombosis and pulmonary embolism are called anticoagulants (blood thinners). These medications don't really thin the blood, but they stop the clotting process and prevent the blood clot from enlarging. The most frequently used anticoagulant medications to treat DVT are heparin, low molecular weight heparin (LMWH), and warfarin. Anticoagulants can cause bleeding, so it is important to be monitored by a doctor when you are taking these drugs.

Newer drugs used to treat DVT and PE include rivaroxaban (Xarelto^®), apixaban (Eliquis^®), and dabigatran (Pradaxa^®).

If you have a PE, emergency treatment at a hospital is needed. PE can be severe and life-threatening, and medicines called thrombolytics can dissolve the blood clot. Anticoagulants will also be given to prevent the formation of more clots. Patients who are at high risk for another PE may need surgery.

Once you had a DVT/PE you are at risk of for another event. Based on follow up studies with patients who had a DVT or PE, it is estimated that about 25% will have another episode. This risk can be decreased by anticoagulation therapy (taking a blood thinner). Unfortunately being on a blood thinner for prolonged periods had risk factors as well. Talk to your doctor about the best approach for your individual case.