In The News

Dr. Jack Oak, St. Luke's Hospital

Deep vein thrombosis and pulmonary embolism

According to recent estimates from the Centers for Disease Control and Prevention, deep vein thrombosis (DVT) and pulmonary embolism (PE) affect approximately 300,000 to 600,000 people each year - with sudden death being the first symptom in about a quarter of those with PE. Pregnant women are at greater risk, and they may not even be aware of the danger.

DVT occurs when a blood clot forms in a large vein. These clots usually develop in the lower leg, thigh or pelvis but can also occur in other veins in the body. PE occurs when part or all of a clot breaks off and travels into the lungs. This may be life-threatening.

When you are pregnant, many changes are taking place in your body. Higher estrogen levels make your blood more likely to clot, and the enlarging uterus can slow blood flow by compressing veins in your pelvis. If you've had a Cesarean section, your blood will form clots to stop the bleeding, and decreased mobility during recovery contributes to an increased risk of DVT/PE. In the weeks after delivery, the changes that took place in your body during pregnancy begin returning to normal.

What are the signs and symptoms of DVT?

• Recent swelling of one limb
• Unexplained leg pain or tenderness
• Skin redness

What are the signs and symptoms of PE?

• Recent or sudden shortness of breath
• Chest pain
• Coughing up blood
• Sudden collapse

What are the risk factors?

• Hospitalization for a medical illness
• Surgery (including C-section) or trauma
• Personal history of DVT or a clotting disorder
• Family history of DVT or PE
• Cancer and cancer treatments
• Increasing age
• Elevated estrogen from fertility treatment, hormone therapy or birth control
• Extended bed rest
• Obesity
• Smoking
• Immobility

DVT and PE can be prevented by exercising regularly, maintaining a healthy weight and by moving around frequently if you sit for a long time. Treatment may include blood-thinning medication, pressure stockings to improve blood flow in your legs or, in occasional circumstances, an interventional procedure to either dissolve the clot or remove it.

Dr. Jack Oak is board certified in vascular surgery and practices at St. Luke's Hospital. Call 314-434-1211 or visit his Physician Referral page.

This article was published in the St. Louis Post-Dispatch on July 28, 2011.