Consequences of DVT
Pulmonary Embolus
Pulmonary Embolus (PE), occurring in about 600,000 patients every year in the United States, is probably the most feared complication of DVT. Left untreated or incompletely treated, all or a portion of a clot can break off and travel to, and block, the blood vessels that supply blood to the lungs. If these blood vessels are blocked to a significant degree not enough oxygen can be delivered to the blood, and excess strain on the heart may result in severe acute heart failure. More than 200,000 patients die of pulmonary embolus every year in the U.S.
If diagnosed and treated in a timely fashion, the mortality rate from pulmonary embolism can be decreased from more than 30% to below 10%.
Like DVT, symptoms of PE can be subtle, but can also be similar to many other cardiovascular problems. These symptoms include:
- Sharp chest pain, often worsened with deep breathing
- Shortness of breath
- Rapid heart beat
- Loss of consciousness
Post-thrombotic Syndrome
DVT is much more than just a swollen leg. Post-thrombotic syndrome (PTS), while not as well recognized as pulmonary embolus, occurs much more commonly as a consequence of DVT. When clot forms in a vein, the unique valves that prevent blood from leaking backward within a vein may be irreversibly damaged. The only way to prevent this damage is removal or dissolution of clot.
When venous valves are not able to function normally, blood cannot easily travel back through the leg to the heart. Subsequently, blood can pool in the muscle bed of the legs and result in inflammation that can have severe negative impact on the patient’s quality of life. Signs of PTS can occur in 50% of patients within one month of DVT. The most severe cases of PTS will result in non-healing ulcerations of the leg or calf. Symptoms of PTS also include:
- Aching or heavy feeling in the legs
- Pain in the legs with activity (venous claudication)
- Chronic, persistent swelling
- Severe skin discoloration and woody, fibrotic hardening of the skin
- Ulceration with possible bleeding, weeping or infection
Ulceration as a result of Post-thrombotic Syndrome.
A large study was performed and published in 2005 in the Archives of Internal Medicine and followed 359 patients who developed DVT and were treated with traditional therapy with blood thinners. The study evaluated and measured quality of life (QOL) scores after the development of DVT.
QOL scores of DVT patients on blood thinners were lower at one month than patients with chronic lung disease and arthritis, and were similar to patients with angina.
QOL scores after four months were similar to patients with chronic lung disease and angina.
One third of patients showed progressive worsening of QOL scores over the four months that they were followed.
