What are deep vein thrombosis (DVT) and pulmonary embolism (PE)?
Deep vein thrombosis (DVT) means thrombosis (clotting) of blood in the deep veins of the legs. It can cause swelling and pain in the leg, but often occurs without giving any symptoms. A DVT may well settle completely, as the thrombosis is dissolved by natural processes. If a DVT extends up the deep veins, two things can happen:
1. The thrombosis can become dislodged from the vein, and get carried through the main veins and heart to lodge in the lungs; this is called a pulmonary embolism. Small pulmonary emboli may cause chest pain, and sometimes coughing up of blood. Multiple or larger pulmonary emboli may cause breathlessness. A large pulmonary embolus which blocks the main blood vessels to the lungs can be fatal.
2. The thrombosis can cause chronic blockage in the deep veins or damage to their valves, leading to long term swelling and sometimes skin problems at the ankle.
Who is at risk of deep vein thrombosis?
We have no direct evidence about people at special risk of DVT as a result of long journeys, but based on evidence about surgical operations the following increase the risk:
The risks of DVT are probably highest for people with more than one of these risk factors.
How do I reduce the risk?
There is now evidence that wearing below the knee graduated compression stockings reduces the chance of DVT for people with special risk factors (listed above). Because so few people without risk factors ever develop DVT or pulmonary embolism as a result of long journeys, there is no definite evidence about other measures which reduce the risk. However, based on what is well known about the causes of DVT and the successful methods of prevention used in hospitals, the following are sensible precautions, particularly on long haul flights and other journeys lasting several hours:
Wear compression stockings: Graduated compression stockings reduce the risk of DVT. They also help to prevent the ankle swelling which many people experience on long journeys. Below-knee stockings are the most comfortable kind, and seem just as effective as full length stockings. Medical graduated compression stockings are supplied in three classes: Class 1 or Class 2 stockings are suitable for most people (Class 3 are excessively strong for this purpose). Compression stockings can be prescribed by a doctor if there is a medical need. The stockings can be bought at chemists, surgical appliance specialists, and now at some other shops, for example in airports. These stockings come in a range of sizes, and your legs will need to be measured to get the right fitting. People who have trouble with the arteries of their legs should seek medical advice before using compression stockings.
REMEMBER – THE RISK OF DEEP VEIN THROMBOSIS ON LONG JOURNEYS IS VERY SMALL.
THE BEST PRECAUTION IS TO STRETCH AND MOVE YOUR LEGS REGULARLY.
Personal Assistant for Mr Adam Howard -
Phone 01206 522413
Mobile & Text 07596 895974
Oaks Hospital, Mile End Road,
Secretary for Mr Adam Howard - Nadine Martin
Phone 01206 742454
Colchester University Hospital, Turner Road, Colchester, Essex