Keep life flowing

On the eve of World Thrombosis Day, we spoke to Dr Rajib Paul, physician and intensivist at Apollo Hospitals, about the growing incidence of the disease in Hyderabad and ways to identify it

Venous Thromboembolism (VTE) is a life threatening medical condition, which includes Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). DVT is a blood clot in the deep veins of a limb (usually lower limb) and when this clot travels to lungs, it leads to PE.

The dangers of VTE lie in the fact that it can affect anyone at any age. It may be acquired in hospitals, through surgery, at home or during pregnancy. Globally, VTE is among the top three reasons for hospital-related diseases and deaths.

VTE diagnosis is difficult and causes immediate death within an average of three hours of manifestation. Studies from India quote an increase in VTE incidence from 28 per cent to 70 per cent. Low awareness of VTE detection and management among the medical community is a concern. Also, many VTE deaths are mistaken for deaths due to heart attacks and strokes.

According to Dr Rajib Paul, physician and itensivist at Apollo Hospitals in Jubilee Hills, there has been an increase in VTE cases in Hyderabad in the past year. Immobility, blood clotting and local injury have been the major risk factors for VTE.

“It is not possible to share exact statistics on VTE cases for India or in any city since there has been no recent documented study on it. However, doctors across the country have reported an alarming increase in VTE cases, which are being diagnosed with more frequency,” informs Dr Paul.

Citing reasons for this increase, he says, “It could be because of prolonged patient stay in ICUs. Or hospitalised patients lying in beds from days to weeks. In addition, patients suffering from chronic heart failure or lung diseases are at a higher risk.”

“VTE is a high risk among patients undergoing surgeries such as hip or knee replacement, bariatric, onco-surgeries. Prolonged immobility during long distance air travel is another cause of concern since the number of air travellers have increased in the past few years. Blood clotting and local injury have also been the major risk factors for VTE,” adds the doctor.

On account of World Thrombosis Day (October 13), Dr Paul highlighted the concern of increasing VTE cases. “Thrombosis is the formation of blood clots, a common occurrence in the human body. However, in VTE the clot travels to the heart or lungs; it can cause sudden death because of the blockage of the blood supply,” he shares.

The theme this year is ‘Know Thrombosis’. Dr Paul says, “It highlights the importance of increasing awareness about Thrombosis and VTE among the general public and the medical community since these are common conditions whose diagnosis can be missed leading to life threatening conditions.”

“We are focusing on the second part of the theme that is ‘Keep Life Flowing’. This highlights that immobility is one of the major reasons for patients developing Thrombosis. It stresses on the importance of maintaining a healthy blood flow in the body to minimise the risk of VTE,” he says.

Death within 3 hours
VTE diagnosis is difficult and causes immediate death within an average of three hours of manifestation. That's a very small window frame. “A major complication of DVT is pulmonary embolism, wherein blood clot moves to the lungs, causing serious damage and eventually death. Any person with DVT who has breathing difficulty, dizziness or sweating, probably may have Pulmonary Embolism.

Such a patient should be immediately admitted to the hospital and administered life-saving thrombolytic drugs,” warns the doctor. Prevention is of course of timely importance. “Any patient with underlying risk factors like heart disease,

COPD, old age who are undergoing surgeries or any condition that results into prolonged immobility, should start on mechanical devices such intermittent pneumatic sequential compression device (IPC) or graduated compression stockings (GCS),” shares Dr Paul.

Look out for these symptoms

Major signs of DVT is swelling and severe pain in the limb (mostly leg) arising from prolonged immobilization or injury.

One should not neglect this and seek immediate medical help. Medical personnel should immediately conduct Doppler ultrasound to confirm DVT occurrence.

Any person with suspected DVT develops following symptoms, which are a sign of possible PE

• Dizziness
• Sweating
• Chest pain that gets worse with coughing or inhaling deeply
• Rapid breathing
• Coughing up blood
• Rapid heart rate