Pink Prescriptions - October 2023
Spot the Clot Blood Clots: Pulmonary Embolism, DVT & Aneurysm
October 2023 Issue — Pink Prescriptions
Spot the Clot Blood Clots: Pulmonary Embolism, DVT & Aneurysm
The scary part of clots in the blood, whether it be a pulmonary embolism, deep vein thrombosis or aneurysm, is not only are they dangerous, they can also be sneaky. They lurk in our veins and often times offer no symptoms. When they finally reveal themselves, it can be too late. The best defense against any type of blood clots is paying attention to even little changes in your body—new aches or pains, swelling, redness, or generally not feeling well. If you have concerns, be sure to see your healthcare provider. The good news is knowledge gives you power, and understanding the risks and symptoms of blood clots may help if you ever suspect one lurking in your own veins. That’s why we asked local experts to tell us more.
By James F. Gigante, MD
What is the difference between a blood clot and DVT? What should I look for with a blood clot?
A blood clot can cause stroke or heart attack when it is located in an artery in the heart or brain. This is called arterial thrombosis. The symptoms are similar to those of a DVT, and include swelling, tenderness, pain, redness, and low blood pressure, among others.
A DVT (Deep Vein Thrombosis) is a blood clot that is located in a deep vein of the leg, pelvis, and on occasion, in the arm. While a DVT does not typically cause a heart attack or stroke, it can travel from these veins to the blood supply of the lung, blocking your pulmonary arteries—this is called a Pulmonary Embolism (PE). A PE can cause you to experience coughing, shortness of breath, and chest pain, among other symptoms. Because those symptoms can be dismissed as something else, a PE can often be unrecognized and untreated, which can result in death. Prompt treatment through blood thinners, other drugs, or medical procedures greatly reduces that risk.
A blood clot can also form at the top of the left side of the heart (atrium), especially those who have a condition called atrial fibrillation. The concern here is that this blood clot can then travel up the aorta and carotid artery and into the brain causing a stroke or Transient Ischemic attack (TIA).
Blood clots in the veins are often associated with risk factors such as, but not limited to: older age; family history; injury; cancer; surgery; weight; and sitting still. You can reduce your risk by exercising, wearing loose clothing, raising your feet above your head, and other actions—discuss these with your doctor.
If you have any symptoms, see a doctor as soon as possible. There are safe treatments for DVTs, PEs and blood clots.
James F. Gigante, MD is a Board-Certified doctor of Internal Medicine and a fellow with the American College of Physicians. He has been practicing medicine for 25 years, the last 17 here in the Lowcountry. 843-681-2222; 35 Bill Fries Drive, Bldg. H, HHI.
by Risa Linford, AGACNP-BC
Beaufort Memorial Pulmonary Specialists
What are the warning symptoms of a Pulmonary Embolism?
Is there anything I can do to reduce my risk of getting one?
A pulmonary embolism is a sudden, life-threatening blockage of the pulmonary artery, usually resulting from a blood clot that has traveled through the bloodstream to the lungs. According to the American Lung Association, pulmonary embolism affects 1 in 1,000 people in the United States every year.Early signs of a pulmonary embolism can vary depending on the size and severity of the clot.
The most common symptoms are:
• Dizziness, fainting • Sudden shortness of breath
• Chest pain—sharp and stabbing; may get worse with deep breaths
• Unexplained cough, sometimes with bloody mucus
Other symptoms may include:
• Blueish lips or nails • Rapid heart rate
• Excessive sweating • Leg pain or swelling
• Upper back pain
There are several things you can do to reduce your risk of pulmonary embolism:
• Stop smoking • Lose weight, if you are overweight
• Stay hydrated • Stay active and exercise regularly
• Avoid long periods of staying still
• Get up and move around regularly when you travel, particularly on longer trips. (Do heel/toe exercises or circle your feet if you cannot get up move around.)
• Talk to your provider about your risks if you are currently taking hormones, whether for birth control or replacement therapy, or during and right after any pregnancy. You should also discuss preventative measures during your hospital stay if you are having surgery.
• Follow self-care measures to keep heart failure, diabetes, or any other health issues as stable as possible
Risa Linford, AGACNP-BC, is a board-certified nurse practitioner with Beaufort Memorial Pulmonary Specialists in Okatie, where she works with patients to prevent, diagnose and and treat acute and chronic conditions of the respiratory system.
By Dr. John Perry | Cardiovascular & Thoracic Surgery Associates, an affiliate of Hilton Head Regional Physician Network
Everyone knows aneurysms can be deadly.
What is an aneurysm?
An aneurysm is an enlarged area in the wall of a blood vessel. An aneurysm can occur when the wall of the blood vessel weakens causing that area to bulge. Aneurysms can occur anywhere throughout the body’s circulatory system, but they are most common along the aorta and in the blood vessels of the brain. If an aneurysm ruptures, it can cause internal bleeding or stroke and can be life threatening. Risk factors for developing an aneurysm include atherosclerosis (hardening of the arteries), high blood pressure, inflamed blood vessels, infection, and trauma.
Are aneurysms preventable?
As I spoke about previously, some common risk factors for developing an aneurysm include atherosclerosis and hypertension. Atherosclerosis is a hardening or thickening of the arteries caused by a build-up of plaque. This can result from conditions such as high cholesterol and/or high triglyceride levels. Hypertension causes an increase in pressure on the walls of the blood vessels. A persistent increase in pressure can cause the vessel to weaken, thus resulting in an aneurysm. Given these risk factors, eating a heart-healthy diet, exercising, maintaining healthy cholesterol levels, controlling blood pressure, and stopping tobacco use can all aid in the prevention of an aneurysm.
Are aneurysms detectable before they become deadly?
There are typically two modes of detection for aneurysms: 1. Symptom development (most commonly sudden onset of pain); and 2. Incidental finding. Aneurysms are actually most commonly found incidentally, meaning they are seen on imaging results when testing for other issues. Once an aneurysm is detected, it is monitored closely to ensure there is no increase in size. If a repair is needed, surgical intervention is an option and has advanced greatly over the years. It can commonly be done percutaneously with a stented graft or conduit without the need for a large incision.
John W. Perry, MD is a board-certified Cardiothoracic Surgeon with Cardiovascular & Thoracic Surgery Associates located on Hilton Head Island. Offering the utmost quality of care right here in the Lowcountry, Dr. Perry is an excellent surgeon who previously practiced with the Cleveland Clinic before joining Hilton Head Regional Physician Network in December 2022.
By Kirsten J. Nelson, M.D., Savannah Vascular Institute
What is a DVT, and what are the symptoms?
DVT stands for Deep Vein Thrombosis. Thrombosis meaning a clot, and Deep Vein meaning it occurs in the large veins which are deep within the legs, arms and the muscles of the thigh and calf. DVT occurs when your blood thickens in a clump that becomes solid, forming a clot. Nearly 300,000 first-time cases of DVT occur in the U.S. every year, usually in the leg. Symptoms may be absent. However, most patients may notice swelling, pain, redness, warmth, or a feeling of heaviness in the affected leg.
How do I know it’s not just a leg muscle cramp?
DVTs typically cause one-sided leg swelling, redness, and warmth that worsens over time. Leg cramps tend to occur at night, come on suddenly, and get better after a few seconds or minutes.
How is a DVT diagnosed?
A Duplex Ultrasound is an imaging test that uses sound waves to look at the flow of blood in the veins. It can detect blockages or blood clots in the deep veins. It is the standard imaging test to diagnose DVT. A CAT Scan (CT) can determine if a blood clot in the leg extends to involve the veins in the pelvis or abdomen. A D-dimer is a blood test that measures a substance in the blood that is released when a clot breaks up.
When do I need to see a vascular specialist?
Your Primary Care Physician may be the first to suspect a blood clot and can refer you to a vascular specialist for an ultrasound or CT scan to check if there is a clot. Treatment for blood clots depends on where the blood clot occurs in the body and the severity of the clot. The primary treatment for blood clots is known as anticoagulants or “blood thinners.” When a DVT is very large, blocks major veins, or produces severe pain and swelling of the limb, treatment may require a Vascular Surgeon or Vascular Interventional Radiologists to perform additional interventions to remove or dissolve the clot. These procedures are done through a small incision in the skin to access the vein and typically only require IV sedation. In some cases, if the vein is scarred or damaged from the clot, a stent may be used to re-enforce the wall of the vein.
Dr. Kirstin Nelson, a Board-Certified Interventional Radiologist with Savannah Vascular Institute, has been performing uterine fibroid embolization (UFE) for more than 15 years, at Savannah Vascular’ s main office in Savannah and now, the new office in Bluffton, which is equipped with a state-of-the-art procedure room. She has a passion for helping women reclaim their life from fibroids. For more information call 912-352-8346.