Health Watch: Why Blood Clots in the legs can be fatal

Serena Williams – a top-ranked tennis player and well-known athlete – suffers from DVT and has experienced two Pulmonary Embolisms (PE). The last one occurred after she gave birth to her daughter in 2017, and it nearly killed her. Thankfully, she recognized the signs and alerted her medical team. Her case has increased awareness.

Blood clots in the deep veins of the legs and pelvis are known as deep vein thrombosis (DVT). Usually, with prompt diagnosis and treatment, DVTs are not life-threatening. However, if a clot breaks free and travels through the veins to the lungs, it’s known as pulmonary embolism (PE), which can be fatal.

The CDC estimates that as many as 900,000 people in the U.S. are affected by DVT and PE each year, and nearly 100,000 people die every year. Most people who die from PE do so within 30-60 minutes of the onset of symptoms, which include chest pain, shortness of breath, rapid pulse, cough.

Unfortunately, PE can be difficult to diagnose and has been called “The Great Masquerader.” It can mimic pneumonia, congestive heart failure, and pleurisy. Risk factors include immobility; smoking cigarettes; being overweight; high blood pressure; cancer; long airline flights; surgery; and trauma.

PE is also associated with women’s health issues such as use of birth control pills, pregnancy, and hormone replacement therapy.  Dr. Matthew Smeds, SLUCare Vascular Surgeon says, "the uterus is pressing the main vein in the belly, which puts a little bit of stasis on the blood flow in your legs."

Treatment involves thinning the blood with anticoagulants immediately. In addition to blood thinners, more aggressive therapies include thrombolytics such as TPA or an embolectomy to remove the PE.  DVT and PE can be treated safely and effectively through a minimally invasive image-guided procedure known as catheter-directed thrombolysis. This clot-busting treatment is performed by a minimally invasive specialist called a vascular interventional radiologist.

Prevention of PE is a lot easier than diagnosis or treatment. Preventive measures may include graduated compression stockings or a prescription of low doses of blood thinners.

To learn more about DVT and PE or to schedule a consultation with SLUCare vascular experts, click here.