The disorder known as DVT (deep venous thrombosis) means having a blood clot in one of your legs. This disorder occurs without warning, resulting in swelling or discomfort of the affected leg. In some cases, a recent leg injury or surgery can be blamed, but most cases are “unprovoked.”
The problem with DVT is that there is a strong association between leg clots and lung clots (pulmonary emboli). Sometimes the leg discomfort is associated with chest pain or shortness of breath, while other cases have no chest symptoms. The concept of having a lung clot causes a lot of anxiety and concern that clotting may be life threatening, though most cases of DVT and PE are not so serious.
When clotting is found, a hematologist should review three issues: (1) the cause of the clotting, (2) how to resolve the clots, and (3) how to prevent future clots.
The cause of the clotting can be a hereditary clotting disorder (genetic mutation) or an acquired disorder (autoimmune). Sometimes testing can reveal these conditions, but most of the time we’re not able to find an answer. In those cases, we say you have a “clotting tendency” even though there is no definable disorder.
To resolve clots, we prescribe anticoagulant medications. Commonly you receive injection medication called enoxaparin while in a hospital, followed by an oral anticoagulant after discharge. Our usual plan is to continue that medication for 3-6 months, depending on the gravity of the clot, and the results of testing done to identify the cause of clotting.
To prevent future clots, we may recommend long-term anticoagulant medications including aspirin or stronger medications. The decision whether to take medication to prevent future clots is customized, depending on the perceived risk and benefit of those medications. A hematologist should be involved to guide you for these decisions.
Heme Onc Call is a telemedicine-based hematology practice specializing in blood clotting disorders. Call for a next-day hematology telemedicine appointment, 786-567-8310, or visit hemeoncall.com.
