Winchester Medical Center

WIN 2015

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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1 1 w w w. s p i r i t o f w o m e n . c o m W I N T E R 2 015 S P I R I T O F W O M E N SHUTTERSTOCK B eing diagnosed with DVT (deep vein throm- bosis) or PE (pulmonary embolism) may sound intimidating, but today's quicker, more accurate testing means you're more likely than ever to be A-OK. Deep vein thrombosis and pulmo- nary embolism are blood clots, in a vein (most commonly a leg vein) or a lung, respectively. While your body is designed to dissolve clots, sometimes a clot in a vein breaks off and travels to the lungs, creat- ing a pulmonary embolism, which can be fatal, says Dr. Sonya Noor, a vascular surgeon affiliated with Kaleida Health, Buffalo, N.Y. But people who develop DVT and get diagnosed and treated within the first three to six weeks can usually avoid vein damage, says Dr. Noor. From interventional radiology to cardiology to vascular surgery, treatment advancements are making it possible to break up blood clots before they have a chance to do damage. GETTING A DIAGNOSIS Both DVT and PE can be detected quickly in a physician's office or emergency room. "When I send patients to the vas- cular lab (for a suspected DVT), they can often get an ultrasound that same day," says Dr. Sarah Lord, an internist who is affiliated with St. Luke's Hospi- tal in Chesterfield, Mo. Physicians use ultrasounds and CT scans to look at veins and find clots in the chest, says Dr. Mark Garcia, chief of vascular and interventional radiology for Christiana Care Health System in Newark, Del., but interven- tional radiology also plays a big part in treatment for clots. according to the doctors. "Every year, there's some new drug or new hope of someone being able to survive," says Dr. Garcia. "We keep coming up with new ways and new technologies, and hopefully it will continue to make a difference." • BLOOD THINNERS AND CLOT BUSTERS The most common treatment for isolated clots, says Dr. Lord, includes blood thinners and monitoring. Dr. Asad Sawar, a cardiologist affiliated with Florida Hospital Tampa in Tampa, Fla., adds that in his expe- rience, medications are usually the first option for clots below the knee, while clots above the knee may need further intervention. PEs also can usually be treated with medication or with suction, he says, but treatment depends on the size of the clot and whether the heart is affected. When more advanced treatment is required, doctors may need to remove the clot through surgery or another procedure. Those who develop post-thrombotic syndrome— which can lead to ongoing leg pain, swelling and immobility—may also benefit from advanced treatment options such as rapid lysis, which Dr. Garcia is credited with designing. It pairs a device called an AngioJet (which delivers a saline solution under high pressure to break up clots) with a blood thinner to treat clots. "We've found that with the combination of those two, patients feel better and it's more effective," explains Dr. Garcia. In her practice, Dr. Noor uses a catheter thinner than a pencil to remove clots, along with clot-busting drugs in a process called thromboly- sis. She describes the process as marinating the clot and then sucking it out of the body. "It's really amazing," she says. "You see a patient come in with massive swelling, and 48 hours later, they're back to normal." Both thrombolysis and rapid lysis decrease trauma to the leg compared with older procedures, Blood clot symptoms Blood clots are very treatable, so if you have symptoms, don't put off addressing them, says Dr. Sarah Lord, an internist with St. Luke's Hospital in Chesterfeld, Mo. Call a doctor or go to the emergency room right away if you notice symptoms of deep vein thrombosis such as: • Swelling, especially in one leg • Leg pain or discomfort • Warmth or redness of the skin Go to the emergency room if you notice symp- toms of pulmonary embolism, which include: • Shortness of breath • Rapid heart rate or breathing • Sweating • Fainting • Coughing up blood Women face some special risk factors for deep vein thrombosis and pulmonary embolism. "Blood clots are more common in high estro- gen states," says Dr. Sarah Lord, an internist with St. Luke's Hospital in Chesterfeld, Mo. Women using birth control pills or those on hor- mone replacement therapy can be at increased risk of developing blood clots. DVT can also develop following pelvic surgery, and pregnancy can be a risk factor. As a result, say physicians, women need to pay particular attention to other blood clot risk factors, which include fying, surgery, immobility, cancer, limb trauma, being 40 or older, obesity and smoking. The women's health CONNECTION

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