Under certain circumstances, clots can form in veins anywhere in the body. The commonest site is in the veins deep inside the legs, and this can cause swelling, pain, warmth, and redness. If a piece of this clot breaks off, it can be carried by the blood flow back to the lung where it lodges in a blood vessel, blocking off the blood supply to part of the lung. This is called a lung embolism. Lung embolism is a serious condition, and a large embolus can be fatal.
Certain conditions can increase the chances of developing a Deep Vein Thrombosis (DVT ) clot ( and therefore an embolism), such as smoking, inherited clotting disorders, heart failure, pregnancy, use of oral contraceptives or hormone replacement therapy, long periods of immobility (e.g. long distance flights), major surgery (e.g. hip replacement) and cancer. An ultrasound and a blood test can confirm the DVT, and the most important treatment is to stabilise the clot to prevent a piece breaking off and lodging in the lungs. For this Warfarin is used, for a minimum of six months and possibly longer, depending on the cause for the DVT. Once stabilised, mild exercise is encouraged to improve blood flow, and in some cases, elastic stockings can help control leg swelling. Persons on Warfarin need regular blood tests to prevent excessive thinning of the blood, and must avoid certain foods and medications. A Medic Alert tag or bracelet is also advised, and any doctor consulted must be informed of the warfarin use to avoid danger drug interactions, e.g. with certain antibiotics or anti-inflammatories. Any signs of excessive bleeding such as coughing or vomiting up blood, blood in the stool or marked bruising of the skin must be reported to your doctor immediately.
A superficial clot with inflammation can cause pain and inflammation (commonly on the inner part of the lower leg.) Clots here are in the veins near the surface of the skin. These clots are smaller than DVT’s, and almost never dislodge to cause lung emboli. They do not require treatment with Warfarin.
There are new products available that have fewer inconveniences than Warfarin – e.g. no dietary restrictions, no need for regular blood testing. However, these drugs are still extremely expensive, and not covered by all medical aids.