British Heart Foundation: Understanding blood clots
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Pulmonary embolism ranks among the third most common cardiovascular disease after coronary artery disease and stroke. Unfortunately, the issue is partly down to a high ratio of delayed diagnoses and misdiagnoses. This was the case for one woman, whose sudden onset of symptoms was put down to asthma.
According to the Centers for Disease Control and Prevention (CDC), Danielle Kahn was just 36 when just developed a cough after returning from a business trip.
She explained: “When I returned to work a few days later, I had developed a strange hacking cough. Inconsistent with being fit from running, I was short of breath and dizzy when climbing stairs.
“I carried on for a few days, thinking I had a bad chest cold and I would be better in a few days.
“Then in the middle of the night, I woke up suddenly, my heart exploding as though I had been sprinting.
“It felt like someone had shot me in the lung, or like cotton was stuffed in my lungs. I didn’t know what was happening to me but I knew I had to get to the hospital.”
Despite having trouble breathing, Danielle was able to drive herself to a nearby hospital where she says she had a poor experience.
According to the CDC report, she was misdiagnosed with asthma and therefore discharged from the clinical unit.
It wasn’t until she eventually secured an appointment with a pulmonologist that she was correctly diagnosed with pulmonary embolism.
The 36-year-old had no risk factors for PE except an hour-long flight and dehydration, which can both cause blood clots.
The JAMA explains: “Long aeroplane flights or multiple flights in a short period can be associated with deep vein thrombosis and pulmonary embolism.
“Any situation in which the leg is bent at the knee for prolonged periods without much active motion may lead to a reduction of blood flow and increase the risk of blood clots.”
Dehydration is equally important to avoid as it causes blood vessels to constrict and the blood to thicken.
Symptoms of deep vein thrombosis
Recognising the signs of a stationary blood clot in the lower limbs (deep vein thrombosis) is essential for preventing pulmonary embolism.
Once a blood clot has formed in the legs it may stay in the same spot or start to move through the body.
According to the Mayo Clinic, deep vein thrombosis can cause:
- Leg swelling
- Leg pain, cramping or soreness that often starts in the calf
- Change in skin colour on the leg
- A feeling of warmth on the affected leg.
In the case where a blood clot leaves the leg and travels to the lung, symptoms may include:
- Sudden shortness of breath
- Chest pain or discomfort that worsens when you take deep breaths or when you cough
- Rapid pulse
- Rapid breathing
- Coughing up blood.
Elderly populations are thought to be at increased risk for PE because of a higher prevalence of medical conditions in this group, and the immobility that accompanied them.
However, Doctor Karlyn Martin, an assistant professor of medicine at the Northwestern University Feinberg School of Medicine in Chicago explains that the condition can strike anyone, regardless of age.
She said: “Unfortunately, PE can strike people at all stages of life, from the young and healthy to the older and not as healthy.”
According to the expert, sometimes it takes patients days or weeks before going to the hospital to get their symptoms checked.
In fact, symptoms of pulmonary embolism, like shortness of breath and mild pain and pressure in the chest, can linger for six weeks or more.
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