Deep vein thrombosis, a silent but deadly killer

Debbie A. Lubis, The Jakarta Post, Jakarta

Planning to go somewhere to spend your holiday? If you're going on a long journey that forces you to stay immobile for hours, either by car or plane, you are prone to getting deep vein thrombosis, or DVT, a blood clotting condition.

The condition can be prevented with light exercise as inactivity can slow the blood flow and block blood circulation in deep veins.

Professor at the hematology division of Jakarta's Cipto Mangunkusumo General Hospital, Karmel L. Tambunan, warned that DVT could cause handicaps and even death. It could also cause sudden deafness, blindness and even miscarriages.

"The blockage of blood flow will disturb the transportation of oxygen and nutrients to the organs and it will cause the network of blood vessels to weaken and die," Karmel said.

The symptoms of DVT may include pain, swelling, discoloration and warm skin. However, most DVT cases produce minimal symptoms.

He said the major risks associated with DVT was the development of pulmonary embolism (PE). A fragment of a blood clot breaks loose from the wall of the vein and migrates to the lungs, where it blocks a pulmonary artery or one of its branches.

"Some seventy percent of PE cases end in the patients' death," Karmel said.

Symptoms may include a shortness of breath, a feeling of apprehension, increased heart beat, sweating and/or sharp chest pains that worsen with deep breathing. Some patients may cough up blood. Others may develop very low blood pressure and pass out.

Karmel said exercising could improve circulation. "People should stand up or wiggle their legs if they are motionless for more than eight hours at a stretch," he said.

Karmel said that chances of DVT were also high among those confined to bed for extended periods, including the elderly, post-surgery patients or the paralyzed.

In addition, hormonal treatment may also increase the risk of blood clotting, particularly when combined with other risk factors like smoking, hypertension, diabetes and obesity.

"Women who use oral contraceptives or undergo hormone replacement therapy are 10 times more likely to develop the disease because those substances can decrease anticoagulants in the body," Karmel said.

Fortunately, the diseases can be prevented and treated effectively, including pulmonary embolism. With early treatment, patients with deep vein thrombosis may reduce their chances of developing pulmonary embolisms.

"Patients at high risk should take anticoagulant tablets or injections regularly. It is more costly and hard to recover if thrombosis has already happened," Karmel said, adding he had had to amputate a 35-year-old the foot of a woman diagnosed with the disease.

"It's hard to cure the network of blood vessels which are already destroyed."