Health x Wellness
“Eyes Open to Thrombosis” campaign spreads awareness about blood clots
World Thrombosis Day is a global awareness campaign led by the International Society on Thrombosis and Haemostasis (ISTH). The campaign seeks to bring awareness to conditions caused by thrombosis, that are responsible for one in four deaths worldwide.
Blood clots are the underlying cause of heart attacks, ischemic strokes and venous thromboembolism (VTE), the top three cardiovascular killers. VTE occurs when one or more blood clots form in a deep vein, most often in the leg (deep vein thrombosis, DVT), and can travel in the blood stream and lodge in the lungs (a condition known as pulmonary embolism, PE).
This year, World Thrombosis Day shines a spotlight on four focus areas and the risk factors associated with VTE blood clots:
- Hospital Associated: Over 50 percent of VTE occur during or after hospital admission.
- Cancer Associated: Patients with cancer are four times more likely to develop a serious blood clot due to effects of the cancer, surgery and chemotherapy.
- Gender Associated: Men are more likely to develop blood clots than women, and when they have a clot, are more likely to get a recurrence than women. Women have periods in their lives where they are at increased risk, for example if they use the combined oral contraceptives or oral hormone replacement therapy and during pregnancy, and six weeks postpartum.
- Mental Health: Increased anxiety, depression and/or post-traumatic stress disorder (PTSD) are common following a physical diagnosis of a blood clot.
Blood clots are often overlooked because their symptoms can resemble those of many other conditions. It is absolutely crucial that both medical professionals and the general public are aware of the signs, symptoms and risk factors to ensure that blood clots are treated as soon as possible.
Professor Beverley Hunt, MD, OBE, Chair of the World Thrombosis Day Steering Committee
The Active Age discusses about deep vein thrombosis (DVT), how it becomes a pulmonary embolism (PE), and how to reduce the incidence of both conditions with Dr Lee Lai Heng, Senior Consultant for Haematology. Dr. Lee has a specialty in Thrombosis and Haemostatis.
the Active Age (AA): What is DVT and how does it form?
Dr Lee Lai Heng (LLH): Deep vein thrombosis or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when something slows or changes the blood flow. Blood thickens and coagulates to form a clot. Most deep vein blood clots occur in the lower leg or thigh, however, they can also occur in other parts of the body such as the arms, or veins within the abdomen and pelvis.
AA: How does a DVT become a PE?
LLH: A blood clot in a deep vein can break off and travel through the bloodstream. The loose clot is called an embolus. It can travel to an artery in the lungs and block blood flow to the lungs, thus cutting off the oxygenation of blood. This condition is called pulmonary embolism, or PE, a very serious condition which can be fatal.
DVT and PE are also known as VTE or Venous thromboembolism.
VTE may be fatal, but the good news is that many if not most cases are preventable. Know the risk factors and discuss with your doctor on prevention strategies and seek medical attention immediately if you experience signs or symptoms of VTE.
AA: Are there things we can do to reduce the incidence of a DVT forming? What are they from both a medical and a lifestyle perspective?
LLH: There are situations and circumstances during which the risks of a DVT are increased, such as prolonged immobilisation, stroke and after surgery, in particular after major orthopaedic surgeries such as hip and knee replacement surgery. There are also medical conditions that increase the risk of DVT such as cancer, autoimmune conditions and infections. A personal past history or family history of VTE also significantly increases the risk of VTE, in particular when other risk factors are also present. When unwell or when hospitalised, it is good to discuss with the doctor regarding preventive measures which include blood thinners and mechanical compression devices to help increase blood circulation.
From a lifestyle perspective, it is prudent to prevent prolonged immobilisation which can occur with long hours of sitting at a mahjong game or desk bound work. When engaged in such activities, do remember to move intermittently with some stretching exercises or taking a short walk. It is always good to have a healthy lifestyle with regular exercises, avoid dehydration, avoid being obese and for smokers, do stop smoking.
AA: Can you tell us more about the link between DVT, PE and patients that have recovered from COVID-19? How concerned must people who have COVID-19 be about this link?
LLH: Significantly increased risks of VTE with COVID-19 infection between 20-40 percent had been reported in the Caucasian populations at the beginning of the COVID-19 pandemic in 2020s.
However, locally in Singapore, we do not see this increased risks of VTE associated with COVID-19 Infections. Even amongst the critically ill patients in intensive care units, where the risks of VTE is highest, only 1.8 percent (or 2 out of 111 patients) was reported (reference: Tan et al. Thrombosis Journal (2021) 19:14).
Preventive measures for VTE for critically ill patients and those requiring oxygen supplement will be assessed for all risk factors for VTE as well as bleeding risks for administration of appropriate VTE preventive measures.
Similarly, we did not observe any VTE reported after hospitalisation discharge for COVID-19 infections. (reference: Int J Lab Hematol. 2022;44:e4–e7). Therefore, we do not advocate preventive anticoagulation treatment for patients recently discharged from hospital for covid-19 infections.
AA: What should people look out for when it comes to seeking to avoid DVT?
LLH: VTE may be fatal, but the good news is that many if not most cases are preventable.
Know the risk factors for developing VTE. When unwell or when hospitalised, it is good to discuss with the doctor regarding preventive measures which include blood thinners and mechanical compression devices to help increase blood circulation.
From a lifestyle perspective, it is prudent to prevent prolonged immbolisation which can occur with long hours of sitting at a majong game or desk bound work. When engaged in such activities, do remember to move intermittently with some stretching excercises or taking a short walk. It is always good to have a healthy lifestyle with regular excercises, avoid dehydration, avoid being obese and for smokers, do stop smoking.
Do seek medical attention immediately if you experience signs or symptoms of VTE.
For more information about World Thrombosis Day and about blood clot risk factors, signs & symptoms, visit their website.
Photo by ANIRUDH on Unsplash and Photo by Gary Butterfield on Unsplash
