Deep vein thrombosis (DVT) is a condition where blood clots develop usually in the deep veins of the legs. Pulmonary embolism (PE) occurs when these clots break away from the walls of the vein and travel to the pulmonary arteries supplying to the lungs through the heart.
In most cases, DVT originates in the calf of the leg. It starts as a persistent cramping or “charley horse” that begins to intensify over a period of several days. The cramping may be accompanied by swelling and discoloration. DVT may also occur in the upper extremity and can cause unexplained upper arm or neck swelling.
DVT, PE, and a combination of both are together referred to as Venous Thromboembolism (VTE).
VTE poses a huge public health threat with an estimated incidence in the United States alone of up to 2 million cases per year.
Predisposition to VTE may develop as a result of acquired or inherited disorders, or both. The majority of the acquired risk factors can be modified, thereby minimizing the chances of developing PE or DVT.
Long-distance travel by air is an often – cited risk factor. Others include obesity, hypertension, cigarette smoking, surgery, immobilization and trauma. Chronic medical illnesses such as chronic obstructive pulmonary disease, congestive heart failure and cancer also increase the risk for PE. For women, there are additional risk factors such as oral contraceptives, pregnancy, and hormone replacement therapy (HRT) that predispose them to develop PE.
Hereditary factors play a very important role in predisposing a person to PE. The presence of these hereditary risk factors in a person is called a prothrombotic or thrombophilic state. Genetic tests (including factor V Leiden and the prothrombin gene mutation) are being developed to identify high – risk individuals.
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