Archive for the ‘Deep vein thrombosis (DVT)’ Category
Dr. Stephan Moll writes…..
When a young person is diagnosed with extensive pelvic DVT or a clot in the big vein in the abdomen, the inferior vena cava (IVC), it is worthwhile to ask whether that person has some congenital abnormality of the IVC, such as a congenital absence or narrowing of the IVC Read the rest of this entry »
CT scans and MRI scans are often done in medicine, for a variety of reasons. Every so often such a scan will detect a blood clot in a patient who has no symptoms from the clot. This is referred to as an “incidental VTE” (VTE = venous thromboembolism, i.e. clot in a vein) or “asymptomatic VTE”. Such a clot may be a DVT in the pelvis or leg, in the major abdominal vein (vena cava), or in one of the intestinal veins (portal vein, splenic vein, mesenteric vein, or renal vein). When such an incidental, asymptomatic VTE is discovered, the question arises whether the patient should be treated with “blood thinners” or not. Read the rest of this entry »
Stephan Moll, MD writes…
What Kind of Clot did You Have?
If you have had a blood clot in your legs or your lung (pulmonary embolism=PE), you will wonder how long you should stay on a “blood thinner”. The decision depends on a number of factors which will be discussed below. Read the rest of this entry »
Testosterone Replacement Therapy
Replacement therapy with low doses of testosterone does not adversely affect blood coagulation status [ref 1] and does not appear to increase the risk of venous or arterial blood clots. Thrombosis is not listed as a potential side effect in a commly used drug compendium (Micromedex). Furthermore, the 2006 “Clinical Practice Guideline” from the Endocrine Society also does not list blood clots as a side effect of testosterone replacement therapy, or a previous history of blood clots as a reason not to give testosterone replacement therapy [ref 2]. However, the Androgel® package insert (prescribing information) lists “blood clots in the legs” as a potential side effect Read the rest of this entry »
What is HHT?
HHT (Hereditary Hemorrhagic Teleangiectasia) is an inherited disorder in which small blood vessels develop abnormally [ref 1]. It is also called Osler-Weber-Rendu syndrome. It is estimated that 30,000 to 60,000 people (1 out every 5,000 to 10,000) in the United States have it. Individuals with HHT develop small abnormal blood vessels (teleangiectasias) under the skin (usually in the fingers and hands) and in the lining of the nose and mouth. Read the rest of this entry »
If you or somebody you know has been diagnosed in the last 14 days with a new DVT of the leg (thigh or pelvic veins), I would encourage you to consider participation in the ATTRACT trial – a solid, clinically useful study (NIH funded) that investigates how to minimize the long-term complications after a blood clot – chronic leg pain and swelling (called the post-thrombotic syndrome).
The study investigates Read the rest of this entry »
Some people have a “hole in the heart”, called a “patent foramen ovale” (PFO). This is a connection between the right and the left chamber (atrium) of the heart. We are all born with it – the unborn needs this connection for proper blood circulation. In most people the hole closes in the first few weeks after birth. However, in up to 25 % of people it stays open, equally often in men and women. A PFO usually does not cause symptoms. However, when a person has an acute DVT (deep vein thrombosis) and a clot breaks off and travels with the blood stream, it may cause problems.
DVT and PE in the person without PFO
In the person who does not have a PFO, a clot that breaks off from a DVT travels with the blood stream through the main vein in the abdomen to the chambers of the right side of the heart (color blue in figure 1 and 2). From there, it travels into the lung vessels, where it gets lodged, causing a pulmonary embolism (figure 1).
DVT (Deep Vein Thrombosis)
A DVT is a blood clot that most commonly occurs in the leg, typically only one leg (image 1). However, occasionally it occurs in both legs at the same time (=bilateral DVT). Sometimes, a DVT is in the pelvic veins or the big abdominal vein (=inferior vena cava). And some DVTs occur in the arm. The anatomy and terminology of leg, pelvic and arm veins (together called “venous clot” or “venous thromboembolism=VTE) is also discussed here.
It is well known that combination contraceptives (containing estrogens AND progestins) increase the risk for blood clots (venous thromboembolism = VTE). Relatively few data, however, have been published on progestin-only contraceptives, so that until recently it has not been clear whether they increase the risk for VTE or not. Read the rest of this entry »
Confusion as to which veins of arms and legs are superficial and which are deep can lead to an incorrect diagnosis. As treatment of clots in superficial veins (= superficial thrombophlebitis) is different to that of clots in deep veins (DVT = deep vein thrombosis), the distinction between superficial and deep veins is important. Read the rest of this entry »