Prolonged sitting during travel or video gaming can
cause venous thromboembolism. Common symptoms of deep vein thrombosis of the lower limbs include pain, swelling and redness of the affected limb.
Venous thromboembolism (VTE),
or the formation of blood clots in
the veins, affects 10 million people
worldwide every year.
A 2007 study in the United Kingdom
of six European Union countries
found that VTE-related deaths
killed more people than Aids,
breast cancer, prostate cancer and
car crashes combined.
The condition is also on the rise in
Singapore.
A 2009 study done by the Singapore General
Hospital (SGH) found
that the percentage of patients with
deep vein thrombosis – a subset of
VTE – increased threefold to 0.45
per cent (495 cases) of the total
number of patients admitted to
SGH, from 0.16 per cent (320 cases)
in the years 1996-1997.
The increase could be due to the
rising proportion of elderly patients
here.
Yet, global public awareness of
the condition and the steps that can
be taken to prevent and treat it
remains low, compared to other
disorders involving blood clotting,
such as heart attacks and strokes.
Here are four things you need to
know about this potentially deadly
condition:
1. WHAT IS VENOUS
THROMBOEMBOLISM ?
Most people have a good idea of
what is involved in a heart attack,
but the term “venous thromboembolism”
is likely to draw blank
looks and some head-scratching.
The term is easier to understand
if it is broken down into parts, said
Associate Professor Lee Lai Heng, a
senior consultant at SGH’s department of
haematology.
A venous thrombosis is the
blockage of a blood vessel by a
blood clot, or thrombus.
A subset of VTE is deep vein
thrombosis, where the blood clot
that forms is found in a vein deep in
the body, usually in the legs.
An embolism is what occurs
when the thrombus dislodges from
where it was formed and travels in
the blood before becoming stuck in
a narrower blood vessel elsewhere
in the body.
Embolisms are dangerous and
can be fatal if the clot ends up in the
lungs, where it blocks some or all of
the blood supply to this vital organ.
Blood clots in the lungs are
known as pulmonary embolisms.
Most pulmonary embolisms are
caused by deep vein thrombosis.
Doctors have combined the two
terms into one – venous thromboembolism
– to refer to the overall
medical condition.
2. WHAT ARE THE
SYMPTOMS OF VTE?
VTE is a silent killer and the
symptoms are non-specific, said
Prof Lee.
Common symptoms of deep vein
thrombosis of the lower limbs include
pain, swelling and redness of
the affected limb.
Patients affected by pulmonary
embolisms can experience shortness
of breath and giddiness.
When the condition is serious,
there may be chest pain, fainting
spells and coughing up of blood.
If it is left untreated, pulmonary
embolisms can lead to sudden
collapse and death.
3. WHAT ARE THE RISK
FACTORS FOR VTE?
VTE is most often due to secondary
causes that result in long-term
immobilisation.
These can include not moving for
many hours following major surgery,
paralysis resulting from
strokes or related conditions, and
prolonged sitting during longdistance
travel or video-gaming
sessions.
Age is a risk factor as well. “The
risk increases sharply after the age
of 40 and peaks for people aged
from 60 to 79 years,” said Prof Lee.
Older people tend to suffer from
chronic illnesses that predispose
them to VTE.
However, deep vein thrombosis
or pulmonary embolisms can also
occur in young people, especially if
they have a family history of VTE.
4. HOW IS VTE TREATED AND WHAT
ARE THE CHANCES OF RECOVERY?
Most people who are otherwise
healthy should aim to prevent VTE
from developing by avoiding
prolonged immobilisation and
dehydration, said Prof Lee.
Early diagnosis can often lead to
recovery, so people with a family or
past history of VTE should inform
their doctors about it when seeking
treatment for related symptoms.
For more serious cases which
require hospitalisation, preventive
measures such as blood-thinning
medication or calfpumps are used.
Blood thinners, also known as
anticoagulants, work by breaking
up blood clots and preventing new
ones from forming.
American presidential candidate
Hillary Clinton takes blood-thinning
medication daily after suffering
deep vein thrombosis in 1998
and 2009, and a blood clot in her
head in 2012 following a concussion.
Calf pumps improve blood circulation
in the legs through compression,
which squeezes blood in the
veins back up the leg and thus
prevents clotting.