SCRIPT NUMBER 138
THROMBOPHLEBITIS / BLOOD CLOTS - 2
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: VENOUS THROMBOPHLEBITIS / BLOOD CLOTS - 2
PROGRAM NUMBER: 138
SUBJECT: CAUSES, SYMPTOMS, COMPLICATIONS, TREATMENT OF
DEEP VEIN BLOOD CLOTS
KEY WORDS: DEEP VEIN CLOT, PULMOARY EMBOLISM, VALVES,
VARICOSE VEINS, SUPPORT STOCKINGS
DATE OF SCRIPT: NOVEMBER 15, 2013
AUTHOR: RICHARD YUKL, MD, FACS
Michelle was a healthy 24 year-old woman who came to a town on the western coast of Namibia in Africa to enjoy the excellent kiteboarding conditions for which the region is known. She was enjoying her sport in perfect weather when, suddenly, a strong gust of wind caused her to lose control of her kite in shallow water. She fell, struck a ridge of sand in the shallow water and broke her leg. The accident prevented her from walking, and on the third morning she was found dead in her bed. A medical examination of her body to determine the cause of her death found that a blood clot had formed in a vein deep in her leg. It had broken free, and traveled through her heart and into her lungs.

Today, I want to talk about blood clots that form in our veins, a condition called thrombophlebitis. Blood clots form as a defense mechanism against damage to a blood vessel. The clot is intended to seal the damaged vessel to prevent possible bleeding. In our legs, the veins are located in two areas - just under the skin and deep within the leg muscles. If a clot forms in a vein just under the skin, it is not dangerous. Y ou will feel a painful “cord” under skin that will hurt more when you put pressure on it. You will also see redness and swelling around the painful cord, but there is no cause for concern. A clot that forms in a vein deep your leg, however, a so-called deep vein blood clot, can break free and travel into your lungs, blocking a major blood vessel. This is what happened to Michelle. The complication is called a pulmonary embolism, and it can kill you. A recent study looking at people who developed a deep vein blood clot found that 3% of those people died within one month.
Other complications can occur because of the way our veins were created. They were created with one-way valves designed to k eep our blood flowing up out of our legs towards our heart, and to prevent our blood from flowing back into our legs due to the effects of gravity.
Clots that form in the deep veins can damage these valves. They will begin to leak, and the blood that flows back towards our legs can greatly enlarge the veins, forming what is known as varicose veins. Our leg may swell, and open sores may even form.

Blood clots form whenever blood flow through a vessel slows, which often happens when a vein is injured. Michelle had direct injury to the veins of her leg, but you can injure a vein in your leg in any number of ways. Your vein may be bruised during a fall, or you may injure it by striking stray debris at work.
Whatever the cause, the injury causes inflammation of the vein, and the inflammation causes the vein to narrow, slowing blood flow. If you are confined to bed for a prolonged time, your blood flow slows, increasing your risk. Pregnancy or being overweight increases pressure on the veins of your abdomen, slowing blood flow out of your legs. Even sitting for hours at a time at work or while traveling on a long trip can cause blood to clot.
You need to be aware of the symptoms that can warn you that a blood clot has formed in a vein deep in your leg. Unfortunately, on rare occasion the blood clot will cause no symptoms. Usually, however, your leg will become swollen, tender and painful, most noticeably when you stand or walk. You may also develop a fever.
Treatment of a blood clot that has formed in the veins of your leg depends on the location of the clot. Clots formed in a vein just under your skin do not require hospitalization. Your doctor may recommend nothing more than applying a warm, wet cloth to heat the painful area several times a day. You can expect the symptoms to improve within a week or two. Medicines that you can buy without a doctor’s prescription can help to lessen the inflammation and pain.

Deep vein blood clots, however, need much more intensive therapy. You will need to wear support stockings continuously to help prevent your leg from swelling. Support stockings help the damaged valves in your leg to function more effectively. Your doctor will prescribe them. If your leg is swollen, you will need to keep it elevated. You will also need a blood-thinning medicine given by injection to prevent the clot from enlarging, and a different blood-thinning medicine given by mouth to prevent other clots from reforming. Because a clot that breaks loose and travels to your lungs can kill you, hospitalization will be required, and surgery may be needed to remove the clot. A filter may need to be placed into the main vein in your abdomen to prevent the clot from travelling into your lungs.
You may wonder how you can prevent blood clots from forming in the veins deep in the muscles of your legs? Blood vessel Injury and physical inactivity pose the greatest risks, so if you must sit for long periods of time at work, or if you have to take a long automobile or airplane ride, get up and take a short walk every hour.
If circumstances prevent you from taking short walks, flex your ankles and press your feet hard against the floor or a footrest at least ten times every hour. Also, avoid wearing cloths that fit tightly around your waist, because they compress your veins and slow blood flow from your legs.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may

differ for your particular health needs. If you need medical advice, please consult a medical professional in your area.