Yesterday, celebrity gossip website TMZ.com reported that legendary rap artist Heavy D died from a blood clot in the lung (Pulmonary embolus or PE) that was caused by Deep leg vein thrombosis. That terminology is incorrect since deep vein thrombosis can occur anywhere in the body, not just the legs. The correct term is Deep Vein Thrombosis or DVT.

DVT has been in the news lately because several high profile figures have been diagnosed with it, or died recently, including Heavy D and reality TV star Tamar Braxton’s husband, Vince Hebert, who survived his bout with DVT and PE.

Pulmonary embolism is usually fatal and involves a blood clot (thrombus) traveling from the legs or arms and into the lungs (PE). People at high risk for DVTs are those who live a sedentary lifestyle (couch potatoes), sit for long periods of time at cubicle desks or travel long distances on planes.

Pulmonary embolisms are often misdiagnosed as something else — such as pneumonia or cardiac arrest. There are law firms that base their entire practice around misdiagnosed pulmonary embolism cases.

Anyone can be diagnosed with deep vein thrombosis. Other risk factors that predispose people to DVTs, include pregnancy, obesity, dehydration, crushing injuries, or people with strokes or heart conditions.

Patients with DVTs or PE are usually young (in their 30s and 40s), and otherwise healthy and athletic. You are at higher risk for a DVT or PE if you sit for long periods of time without stretching your legs or walking, regardless of your health status.

A deep vein thrombosis occurs when the blood in the veins begins to clot due to an obstruction. A clot then breaks off in the leg or arm and travels through the venous network to the heart where it is pumped into the lungs causing an obstruction in a pulmonary artery that could lead to sudden death.

Deep vein thrombosis occurs in the veins because the blood in your veins is not under as much pressure as the blood in your arteries. Venous blood is depleted of oxygen and makes the slow return trip to your heart and lungs where it picks up more oxygen. Because it is not under as much pressure as your arteries, venous blood is easier to clot if it is obstructed, such as when sitting.

There are two places where the venous blood can easily be obstructed when you sit: your lower legs (below your knees) and your thighs where they meet your groin. Your sitting position causes your blood to slow down in those areas. If you are obese, your blood slows down even more, causing clots.

The reason people don’t usually drop dead right away on planes is because the blood clot is still attached to the inside wall of your vein in your leg (or arm) where it begins to irritate your vein.

Sufferers report feeling a dull ache or sharp pain in the back of their legs or arms. The area may also swell, turn red or a ruddy color, and feel hot (or cold) to the touch. You might also have a positive Homan’s sign.

When you stand up and walk around, your venous blood flow starts moving normally again and the clot loosens and breaks off to make the slow trip to your heart and lungs.

Signs and symptoms of DVT (signs are what you see and symptoms are what you feel):

  • Swelling in one or both legs
  • Pain or tenderness in one or both legs, which may occur only while standing or walking
  • Warmth in the skin of the affected leg
  • Red or discolored skin in the affected leg
  • Visible surface veins
  • Leg fatigue

    • If you have any of the above signs and symptoms, it is important that you get to a doctor or emergency room right away! If you are athletic, do not assume that the signs & symptoms are just muscle pain.

    The best way to avoid getting DVTs, which can lead to Pulmonary emboli, is to get up and move around at least every 2 hours while you’re at your desk or on a plane.

    Also drink lots of water. The air on planes is much dryer than on the ground, and dry air increases dehydration in the body.

    Dehydration causes your blood to thicken and clot easier. Doctors suggest that you drink 2 liters of water per day (or 8 cups of water) to prevent dehydration. You should drink more if you are very active. The average person loses 1.5 liters of water per day in urine. An additional liter is lost just by breathing, sweating, talking or coughing per day. Food accounts for 20% of our daily water intake.

    Treatment for DVT includes medications, such as blood thinners (Coumadin or Heparin, etc). Some doctors may prescribe Aspirin once a day since aspirin contains a blood thinner. Doctors might also insert an IVF (inferior vena cava filter) to trap blood clots before they reach the heart and lungs. You may also be advised to wear compression stockings to decrease the swelling in your legs.

    This has been your medical minute.

    More Info On The Web

    Deep Vein Thrombosis – WebMD

    Deep Vein Thrombosis – MedicineNet

    Deep Vein Thrombosis(DVT) – Mayo Clinic

    Deep Vein Thrombosis (DVT) – eMedicine Health