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Venous thromboembolism (VTE)

What is venous thromboembolism?

Venous thromboembolism (VTE) is the formation of a blood clot in a vein. 1
The term covers two, related conditions:

  • Deep vein thrombosis (DVT)
  • Pulmonary embolism (PE), which may be a complication of DVT 

 

VTE can be caused by long periods of inactivity (such as long-haul flights or being confined to a hospital bed); blood vessel damage: pregnancy; or contraceptive therapy. It is also associated with some medical conditions, including cancer and rheumatoid arthritis. However, often the cause is unknown.

 

What might you experience with DVT?

Deep vein thrombosis (DVT) occurs when blood clot blocks one of the deep veins, usually in the legs. You should see a doctor immediately if you experience DVT symptoms (listed below)

 

Venous thromboembolism (VTE)

Possible symptoms of DVT in your leg:

  • Pain, swelling or tenderness (usually in your calf)
  • A heavy ache in the affected area
  • Warm skin around the area of the blood clot
  • Red skin, particularly at the back of your leg below the knee
  • Or, no symptoms at all in some cases

 

 

Did you know that DVT can cause blood clots elsewhere?

Sometimes a fragment of blood clot breaks free and travels away via the bloodstream (an embolus). An embolism is the resulting blockage, which can occur when a fragment becomes lodged in blood vessels elsewhere in the body.

 

An embolism can get stuck in any small blood vessel. Common sites are in the legs or the lungs. 2

 

Venous thromboembolism (VTE)

 

What might you experience with PE? 3, 4

A PE is a medical emergency requiring hospitalization and you should see a doctor immediately if you experience symptoms.

 

Venous thromboembolism (VTE)

 

Possible symptoms of PE in your lung:

  • Feeling short of breath, which may come on gradually or suddenly
  • Pain in your chest or upper back, which may worsen when you breathe in
  • Coughing (usually a dry cough)but you may cough up blood, or mucus that contains blood
  • Feeling lightheaded, dizzy, faint, or suddenly collapsing

 

How can you reduce your risk of VTE? 5

  • Maintaining a healthy lifestyle can help reduce your risk of VTE
  • Quit smoking
  • Eat a healthy, balanced diet avoiding high-fat foods and saturated fats
  • Maintain a healthy weight or lose weight if you are obese
  • During long haul flights, wear compression stocks or socks, exercise your feet and ankles to encourage blood circulation and drink plenty of water
  • Take regular exercise

 

What are the DVT & PE treatments? 6, 7

Heparin and oral anticoagulant (warfarin and NOACs e.g. Edoxaban, Dabigatran, Rivaroxaban, Apixaban) are two types of anticoagulants that are used to treat DVT & PE. Heparin is usually prescribed first because it works immediately to prevent further clotting. After this initial treatment, you may also need to take warfarin or NOACs to prevent another blood clot forming.

 

Heparin

 

Heparin is available in two different forms:

  • unfractioned heparin
  • low molecular weight heparin (LMWH)

 

LMWH is usually given as a subcutaneous injection. LMWH works differently from standard heparin. It contains small molecules.

 

Both standard heparin and LMWH can cause side effects, including:

  • a skin rash and other allergic reactions
  • bleeding
  • weakening of the bones if taken for a long time (although rare with LMWH)

 

Oral Anticoagulant 8

Oral anticoagulants are usually recommended after initial treatment with heparin to prevent further clotting of blood. The recommended treatment duration can range from 3 to 6 months or in some cases, lifelong.

 

Available oral anticoagulant:

  • Warfarin
  • Lixiana (Edoxaban)
  • Dabigatran
  • Rivaroxaban
  • Apixaban

 

References

1. Deep Vein Thrombosis, NHS Choices. Available at: http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Introduction.aspx. Last accessed: June 2016

 

2. Deep Vein Thrombosis, Patient. Available at: http://www.patient.co.uk/health/deep-vein-thrombosis-leaflet. Last accessed: June 2016

 

3. Prevention and Treatment of Venous Thromboembolism. International Consensus Statement (guidelines according to scientific evidence). International Angiology 2013:32(2):1-169. Available at: http://europeanvenousforum.org/wp-content/uploads/2015/02/IUA_Guidelines_2013.pdf. Last accessed: June 2016

 

4. Pulmonary Embolism, Symptoms. NHS Choices. Available at: http://www.nhs.uk/Conditions/pulmonary-embolism/Pages/Symptoms.aspx. Last accessed: June, 2016

 

5. Preventing Deep Vein Thrombosis, NHS Choices. Available at: http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Prevention.aspx. Last accessed: June, 2016

 

6. Pulmonary Embolism- Treatment, NHS Choices. Available at: http://www.nhs.uk/Conditions/pulmonary-embolism/Pages/Treatment.aspx . Last accessed: June 2016

 

7. Treating Deep Vein Thrombosis (DVT), NHS Choices. Available at: http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Treatment.aspx. Last accessed: June 2016

 

8. Lixiana Prescribing Information. Daiichi Sankyo HK Limited Sept 2016


 

The above information is provided for your reference only.
Please consult your doctor if you have any enquiries.

Disease Information

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