Venous Thromboembolism

Symptoms of VTE can be different based on whether you have a DVT or a PE. Symptoms of VTE vary, and some people may not notice any signs until complications arise. However, knowing what to look for can help catch it early:

• DVT symptoms: Swelling in the legs (or sometimes arms), pain or tenderness, often in one leg. The area might feel warm, and the skin may appear red or discolored.
• PE symptoms: Sudden shortness of breath, chest pain that gets worse when you breathe deeply, a rapid heartbeat or coughing (sometimes with blood). If these symptoms occur, it’s important to seek medical help immediately. 

Blood clots form naturally to heal damaged vessels and stop bleeding. However, some individuals are at increased risk for abnormal clotting, even without injury: Age is one of the most important risk factors for VTE, but multiple other risk factors also raise the likelihood of developing the problem. 

Age, sex and family history

• Age and sex: Risk increases with age, especially over 40. Before menopause, women have a higher risk of VTE compared to men, partly due to hormonal changes.
• Family History and Genetics: If family members have had blood clots, your risk is higher due to shared genetic traits that may affect clotting.
• Hormonal factors: Birth control pills, hormone therapy, and pregnancy increase clotting risk.

Lifestyle

• Immobility: Long periods of not moving (e.g., after surgery, during bed rest or long flights) can slow blood flow and lead to clot formation.
• Smoking
• Obesity

Medications and medical conditions

• Certain medications (like hormonal birth control) can elevate the risk.
• Medical conditions: Congenital blood clotting disorders, a variety of heart diseases, infections (like COVID-19) or kidney disease increase the chance of VTE.
• Cancer and chemotherapy: Certain cancers and their treatments can make blood clots more likely.

Diagnosis of VTE starts with an evaluation of symptoms, medical history and risk factors. Your healthcare provider may order tests to help diagnose DVT or PE. Common diagnostic methods include:

• D-Dimer blood test: A blood test that measures substances released when a blood clot breaks down. High levels can indicate a clot but aren't conclusive on their own.
• Compression Ultrasound: A non-invasive test using sound waves to detect blood clots in deep veins, typically in the legs.
• CT Scan (CTPA): A CTPA, or Computed Tomography Pulmonary Angiography, is a medical imaging test used to find clots in the lungs.
• Other imaging tests: Magnetic resonance venography or pulmonary angiography may be used in special cases to provide clear images of veins or blood flow.

Early diagnosis is key to preventing serious complications, so talk to your provider if you are at risk or notice any symptoms.

• If you have surgery or are hospitalized. VTE risk is higher after surgery or during extended hospital stays due to immobility. Your healthcare team may recommend:
  • Staying active: Move around as soon as possible, even if it’s simple stretching exercises.
  • Wearing compression stockings or devices: These help keep blood flowing in your legs.
  • Blood thinners: Medications to prevent clot formation before and after surgery, especially for major procedures.
• Preventing VTE while traveling. For flights or car trips over 4 hours, increase blood flow by:
  • Standing up, walking or stretching regularly.
  • Wearing loose clothing and compression socks.
  • Staying hydrated and avoiding alcohol.
• Healthy lifestyle choices. Maintaining a healthy weight, being physically active and quitting smoking can lower your risk of developing VTE.

If you’ve had VTE, it’s important to work with your provider to prevent future clots and manage any complications:

• Regular checkups: Monitor your symptoms and any side effects from medications.
• Post-Thrombotic Syndrome (PTS): Chronic swelling and discomfort in the affected leg or arm due to DVT. Compression stockings may relieve symptoms.
• Pulmonary hypertension is a potential long-term effect of PE, causing high blood pressure in the lungs and making breathing difficult.

 It’s essential to recognize signs of potential complications and inform your provider immediately if you have new symptoms. 

Healthy lifestyle changes

After VTE, your provider may recommend lifestyle changes to support recovery and prevent repeat events:

• Heart-healthy eating: Include a balanced diet with fruits, vegetables and lean proteins. If you are on blood thinners like warfarin, keep vitamin K intake consistent.
• Regular activity: Move often and exercise as recommended by your healthcare team.
• Stress management: Reducing stress can help improve overall health.
• Quitting smoking: If you smoke, seek support to quit, as it reduces your VTE risk and benefits heart health.

Women and VTE

Women using hormonal birth control, undergoing hormone therapy, or who are pregnant are at higher risk for VTE. Talk to your provider about your options, especially if you have other risk factors for blood clots. During pregnancy and the first 6 weeks after giving birth, the risk of blood clots is also higher. If you need bed rest during pregnancy or have a C-section, discuss VTE prevention with your provider.