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Newtown Physician Details Potentially Deadly Effects Of DVT

Published: August 15, 2016 at 12:00 am

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Deep vein thrombosis is something that is easy to understand according to Newtown physician Alex Afshar, MD a phlebology expert at the Vein Institute at 33 Church Hill Road.

"It's a clot," Dr Afshar said.

But that simple description in no way diminishes the seriousness of DVT or the clots that can form, most often in the leg or lower extremities, and which could result in a blockage called pulmonary embolism (PE).

If the clot is small, and with appropriate treatment, people can recover from PE. However, there could be some damage to the lungs. If the clot is large, it can stop blood from reaching the lungs and is fatal, according to the Centers for Disease Control and Prevention (CDC).

The good news, Dr Afshar said, is that DVT is preventable and treatable if discovered early.

"They can be life-threatening, but they can be easily detected and treated," he told The Newtown Bee during a recent interview. "It's very important for Newtown residents to know about these clots or DVTs."

While most DVTs happen in lower extremities, Dr Afshar has seen clots forming in the hip, particularly after hip reconstruction or replacement surgeries, as well as occasionally in the arms.

"Most of the time it's the clots that form in the hip that travel to the lungs," he said. "The clots from the leg or calf can travel to the lungs, but they usually travel to the hip. Which can buy you some time."

Close to 50 percent of DVTs result in a PE, he said.

"It's important to note that the chance of getting DVT in the upper extremities is low, but those clots produce a much higher risk of pulmonary embolism," he said. "Pregnancy is another condition that can increase one's risk for DVT."

Dr Afshar said about 2.5 million people every year in the US experience a clot, which results in about 600,000 hospitalizations.

"That is a significant number by any standards - 50,000 people every month," he said.

A PE occurs in six to ten percent of patients who are diagnosed with a clot from the upper extremity, and about 15 to 30 percent with a clot developing in the lower extremities, he said.

"So it's the most prevalent form of cardiovascular illness after acute coronary syndrome and stroke," he said. "And when it becomes a PE, it becomes the third leading cause of hospital-related death.

"Ironically, it is also the most preventable cause of hospital-related death," he added.

Clots form when the blood thickens - through lengthy immobility, in patients who are experiencing or have experienced cancer, commonly in some orthopedic surgeries, he explained, and others are genetically predisposed to developing clots, primarily African Americans.

"I want to say that the genetic factor is less common than immobility and cancer," he said. "Those with cancer experience hypercoagulable blood, so it's easier to form a clot."

Interestingly, Dr Afshar said occasionally patients seeking treatment for DVT could lead their physician to discover that he or she also has cancer.

Signs and symptoms of DVT include calf tenderness or pain; shortness of breath, which is usually a sign that a PE is occurring; you could get chest pain, or anxious, he said.

Fortunately, a quick, easy, and relatively inexpensive ultrasound image can reveal a patient's DVT.

"If it is diagnosed, it can be treated with long- or short-term anticoagulation medicines," he said.

Since immobility tends to increase with aging, Dr Afshar sees more incidents of DVT in his older patients. But most recently, he has learned that visual vein disease is also a contributor to the condition.

"Varicose veins, spider veins, heavy legs or restless leg syndrome, or swelling can lead to venous insufficiency, which increases the chances of forming DVT," he said.

Unfortunately, Dr Afshar said, DVT happens quickly and often with little or no warning, so it cannot be monitored through a patient's course of annual physical exams.

"Almost all our patients are being treated for venous insufficiencies," he said. "And here in this office, we usually can diagnose DVT within an hour."

The CDC states that nearly one-third of people who have a DVT will have long-term complications caused by the damage the clot does to the valves in the vein called post-thrombotic syndrome (PTS).

People with PTS have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the affected part of the body. And in some cases, the symptoms can be so severe that a person becomes disabled, the CDC states.

For some people, DVT and PE can become a chronic illness; about 30 percent of people who have had a DVT or PE are at risk for another episode.

To consult with Dr Afshar, call 203-486-8521, or visit veininstitutect.com.

Preventing DVT


According to the US Centers for Disease Control and Prevention (cdc.gov), the following tips can prevent deep vein thrombosis or DVT:

*Move around as soon as possible after having been confined to bed, such as after surgery, illness, or injury.

*Wear loose-fitting clothes.

When sitting for long periods of time, such as when traveling for more than four hours:

*Get up and walk around every two to three hours.

*Exercise your legs while you're sitting by:

*Raising and lowering your heels while keeping your toes on the floor

*Raising and lowering your toes while keeping your heels on the floor

*Tightening and releasing your leg muscles

You can reduce your risk by maintaining a healthy weight, avoiding a sedentary lifestyle, and following your doctor's recommendations based on your individual risk factors.

And if you are at risk for DVT, talk to your doctor about:

*Graduated compression stockings (sometimes called "medical compression stockings")

*Medication (anticoagulants) to prevent DVT.

Learn more at cdc.gov/ncbddd/dvt/facts.html.

 

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