100,000 Die Annually—

Leg Pain Can Signal Deadly Blood Clot

WASHINGTON, D.C. (AP) — Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time.

“It’s a silent killer. It’s hard to diagnose,” said Acting Surgeon General Dr Steven Galson, who announced the new campaign Monday. “I don’t think most people understand that this is a serious medical problem or what can be done to prevent it.”

At issue are clots with cumbersome names: a deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE.

These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or being in similarly cramped quarters. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the invasion of Iraq.

But that provides a skewed vision of the problem. While there are not good statistics, the new surgeon general’s campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die.

There are a host of risk factors and triggers: recent surgery or a broken bone; a fall or car crash; pregnancy or taking birth control pills or menopause hormones; being immobile for long periods. The risk rises with age, especially over 65, and among people who smoke or are obese.

And some people have genetic conditions that cause no other symptoms but increase their risk, making it vital to tell your doctor if a relative has ever suffered a blood clot.

People with those factors should have “a very low threshold” for calling a doctor or even going to the emergency room if they have symptoms of a clot, said Dr Galson, who issued a “call to action” for better education of both consumers and doctors, plus more research.

Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply.

But here’s the rub: doctors are ill-informed, too. For example, studies suggest a third of patients who need protective blood thinners when they enter the hospital for major surgery do not get them.

These clots “tend to fall through the cracks” because they cross so many areas of medicine, said Dr Samuel Goldhaber, chairman of the Venous Disease Coalition and a cardiologist at Boston’s Brigham & Women’s Hospital.

With the surgeon general’s campaign, “DVT after all these years will finally get the national spotlight like cigarette smoking did in the mid-60s,” he said.

In addition to Dr Galson’s report:

*The Agency for Healthcare Research and Quality is issuing a 12-page booklet to help consumers tell if they are at risk for DVTs and what to do — and a 60-page DVT treatment-and-prevention guide for doctors and hospitals.

*As a prevention incentive, starting October 1 Medicare will withhold payment from hospitals when patients develop the clots after knee- or hip-replacement surgery.