Z. Goldhaber, MD,
is the co-chair of the Council for Leadership on Thrombosis Awareness and
Management, a group of 11 medical experts formed to raise awareness about
blood clots. Dr. Goldhaber is Associate Professor of Medicine at Harvard
Medical School and the Director of the Venous Thromboembolism Research Group
and Medical Director of the Anticoagulation Service at Brigham and Women's
is an internationally recognized authority on pulmonary embolism. His
research focuses on the epidemiology, diagnosis, treatment, and prevention
of pulmonary embolism and deep venous thrombosis.
Blood Clots: An Overlooked Women's Health Issue
Each year, two million Americans develop deep-vein thrombosis (DVT), a blood
clot in the deep veins of the leg that if untreated may travel to and lodge
in the lungs, causing death. Blood clots in the lungs, also known as pulmonary
embolism (PE), kill up to 200,000 people each year. Blood clots can affect anyone
from Olympic athletes to ailing senior citizens, and women are prime candidates
for this condition.
How do I know if I am at risk?
The risk of developing blood clots is greater for women who have one or several
of these risk factors:
- Pregnancy: a woman's risk of developing blood clots is six times greater
when she is pregnant. During pregnancy estrogens are elevated in the blood
and studies have shown that estrogen increases blood clotting.
- Birth control pill: oral contraceptives that contain progesterone are associated
with increased risk. Women who had progesterone skin implants also carry
a risk of DVT and PE.
- Hormone replacement therapy: any HRT that contains the hormone estrogen
(also known as estrogen replacement therapy) or progesterone may increase
the risk of blood clots.
- Varicose veins: these veins in the leg are distended, lengthened and twisted,
making blood flow slower than normal.
- Prolonged immobility: people who are immobile for a long period of time,
such as bedridden patients or those on long plane flights, are particularly
at risk for developing blood clots since the blood circulation is slower than
Other risk factors include obesity, history of DVT, certain types of cancer,
stroke, chronic heart or respiratory failure, and surgery including orthopedic,
pelvic and abdominal surgeries. The risk of developing blood clots also increases
How do I recognize the symptoms?
Common symptoms of DVT include swelling, redness and pain in the affected leg
(sort of a "charley horse" that persists), and sometimes warmth in
the calf or thigh. In many cases, people develop DVT without any warning sign.
Patients with PE are more likely to experience symptoms, and these include shortness
of breath, sudden onset of chest pain, cough, and fainting. Obviously, these
symptoms require immediate medical attention.
What can I do to prevent and treat blood clots?
Though potentially dangerous and sometimes difficult to diagnose, DVT can be
easily treated. Conventional treatments to improve the blood circulation include
elevation of the affected leg, use of compression stockings, and leg exercise.
Anticoagulants, or blood-thinning drugs, such as heparins and low-molecular
weight heparins, help prevent DVT and PE by impairing the body's normal blood-clotting
process. Enoxaparin sodium, which requires a subcutaneous injection, can even
be administered at home and does not require monitoring.
Where can I find more information on blood clots?
The Council for Leadership on Thrombosis Awareness and Management, comprised
of eleven medical experts affiliated with leading U.S. institutions, has launched
the ClotAlert™ Resource Center, a program to educate Americans about blood clots.
If you need more information and would like to receive materials, call the ClotAlert™
Resource Center at 1-800-CLOT-FREE.
Click here for more information.
Created: 5/4/2002  - Samuel Z. Goldhaber, MD