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Blood Clots (cont.)

How can blood clots be prevented?

Prevention is always the key in medicine. This is especially true when it comes to many of the diseases associated with blood clots.

  • Risks of arterial blood clots associated with heart disease, stroke, and peripheral artery disease may be minimized by keeping high blood pressure, diabetes, and cholesterol levels under control. Smoking cessation should be a priority.
  • Deep vein thrombosis and pulmonary embolus prevention is a priority in hospitalized patients. Often those undergoing surgery are aggressively encouraged to start walking as early as possible, and medications may be used prophylactically to prevent clot formation.
  • Travelers should be encouraged to get up, stretch, and walk routinely. This is especially true on long airplane trips or long car rides.
  • Hormone therapy is a risk for blood clot formation, and smoking compounds that risk. People who choose to smoke should notify their health-care professional; the benefits of birth control and/or hormone therapy will need to be balanced against the risk of complications.

What is the outlook for a person with a blood clot?

There are many patients who don't know that they have had a blood clot in their leg, either because the symptoms were mild, or those symptoms were ignored. Up to 25% of patients with a pulmonary embolus die from sudden death.

For those patients with a provoked deep vein thrombosis, one where the cause is known and is temporary, there is a small risk of future bloods clot once the initial anticoagulation treatment is complete.

For patients who have an unprovoked DVT or PE or who have active cancer or a blood clotting disorder that makes their blood more likely to clot, lifelong anticoagulation may be required. Guidelines suggest that this decision be revisited every year.

For all patients, the patient and the health-care professional need to balance the benefit of anticoagulation against the complication risk of bleeding. The doctor will try to match the blood thinning drug with the patient's situation, to minimize that risk of bleeding.

REFERENCE: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2_suppl).

Last Reviewed 8/30/2017

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