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Heart & Vascular Health | Vascular (Peripheral Arterial Disease)
traffic jam on highway

What Everyone Should Know About Blood Clots

To prevent deep vein thrombosis, get up and move often

Just like a traffic jam on the highway, blood clots impede normal circulation in your body and can be dangerous. Here are some blood clot basics and information on steps you can take to help avoid the problem.

Signs of a serious blood clot

Thrombosis is a medical term for blood clot. Deep vein thrombosis (DVT) occurs in one of the large veins, usually in your legs. DVT can cause pain and swelling in the area where blood clots form. The area might also be reddened and feel warm to the touch.

The most common complication from DVT is pulmonary embolism (blockage), which occurs when a clot or part of a clot breaks off and lodges in the lungs. Symptoms of pulmonary embolism include shortness of breath and sudden pain in the chest that gets worse when you breathe deeply.

Risk factors and ways to avoid DVT

Anybody can get DVT, but surgery or injury increases your risk, as does increasing age and weight gain. Some people have clotting disorders that increase their risk for DVT.

Ways to avoid DVT include:

  • Quitting smoking, maintaining a healthy weight and exercising regularly.
  • If you are hospitalized, ask your healthcare providers about available DVT prevention, such as mechanical devices to aid circulation.
  • If you are on a long flight, or if you sit for hours, wear compression stockings and get up and move around or perform stretching exercises.

“As many as 60 percent of all people who suffer an episode of deep vein thrombosis will also develop post-thrombotic syndrome,” says vascular medicine specialist Natalie Evans, MD.  

This syndrome can cause long-term pain, swelling and even ulcers.

Blood thinners and what not to eat

Physicians prescribe blood thinners to some DVT patients to prevent future clotting. Warfarin or Coumadin is a type of blood thinner that has been used for decades, but frequent blood tests are needed to monitor dosage.

Dr. Evans adds, “Patients should talk with their doctor or pharmacist…to learn about potential interactions with foods and drugs.”

The Vitamin K found in greens and other foods can interfere with Coumadin’s effects. There’s a long list of foods that you should eat only in moderation while you are on the drug.

Cranberries and cranberry products like cranberry juice can intensify Coumadin’s effect, so it’s best to avoid them while you are on the drug.

Pros and cons of new medications

Newer blood-thinner medications, including rivaroxaban (Xarelto), apixaban (Eliquis) and dabigatran (Pradaxa), can be used for DVT prevention and do not require frequent blood tests, making them more convenient.

These new-generation blood thinners also may have fewer negative interactions with foods and other drugs. However, they are also more expensive than warfarin, and a specific antidote, in cases of bleeding, is not available. Patients should talk to their physician about the risks and benefits of taking these medications.

Beware of high impact sports

If you’re taking blood thinners, participating in high-impact sports can lead to potentially dangerous bleeding. Dr. Evans says that during exercise, “people who’ve had DVT and PE in the past need to be aware of the symptoms of recurrent clots, that is, leg pain and swelling, shortness of breath, chest pain that’s worse with deep breathing.”

While you are on blood thinners, there’s always a danger from cuts or bruising, even in going about your everyday activities like shaving or gardening.

Keep a medical card in your wallet that says you are on blood thinners, and never take any prescription or non-prescription medications without talking with your doctor first.

Tags: blood clots, blood thinners, deep vein thrombosis, DVT, heart and vascular institute, vascular disease
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  • Chris Weigand

    I developed a superficial blood clot while on a car trip in a 3 hour traffic jam….later I learned that being dehydrated contributes to these clots but in a traffic jam, you are not likely to be drinking a lot when you can’t get off the highway….it caused my leg to swell and turn red and a red line was further up the leg by the next day….a quick trip to emergency confirmed it was only superficial thank goodness…

    • The_Beating_Edge_Team

      Chris – Dr Evans is hosting a web chat tomorrow – I will ask her about this. Thanks for commenting.

  • Linda J Luce

    Years ago I had a mini stroke, clot in my brain. Then they found clots in my lungs, a couple times of DVD. Was going to doc at least once or twice a week trying to get inr at therapeutic level. Fast forward many years,

    I didn’t feel good I guess ( I can’t remember any of this but it’s what my family has told me) so I drove myself to hospital, my tummy hurt, they called my daughter to take me hom, I had the flu ,& gave me some morphine for pain.
    Went home dad said I was moaning and groaning all night, at 5:30 am he took me back to the er, they did some tests , packed me up in the ambulance, for a ride to a hospital almost two hours away, I guess they did more testing, an in ended up having emergency surgery, where they repaired my mesentaric artery, and they removed four feet of my intestine. Due to Blood Clots. It took me awhile to come completely out of anesthic ( I guess for a few days I was incoherent)- I have a theory on that but I did finally come back to normal. They sent me home with lovonaux shots, and coumidin. With a visit scheduled for a week later, my inr was about 9, so I was in the hospital getting , transfusions. And plasma for Christmas dinner.

    I then a week after being released saw ,my regular dr. And having regular inr checks

    • Linda J Luce

      After a month, I have been at a therapeutic level, have ck. up Wednesday.
      Stick wit a dr that is going to test your blood, stick with you, and not throw his hands in the air and gives up
      Buy the way I am still recovering from surgery, two months later.
      My story Linda luce

    • The_Beating_Edge_Team

      Linda – You have been through a lot. I am hoping you are doing better now. It sounds like you may have some type of Hypercoagulable or Clotting disorder – you should see a specialist in that area. We have a Thrombosis Center – it may be worthwhile to get an in-person or a web-based second opinion consultation on why you have had so many of these issues. See http://my.clevelandclinic.org/heart/departments-centers/thrombosis.aspx or seek a specialist close to home who specializes in this area. betsyRN

    • Lilywhiteazz

      I am an anticoag nurse at a large clinic. We check INRs within 3 days of being discharged from the hospital. We check twice a week for the first couple of weeks, then once a week for 2 weeks then every 2 weeks for 2 times and then every 4 weeks. I am many hundreds of miles from Cleveland, but I will tell you this: when I needed a cardiologist I looked for someone who did fellowship at the Cleveland Clinic. I was very lucky to find both a regular cardiologist and an electrophysiologist who did fellowships there, and they are in the same practice.

  • Modges

    I suffered a life-threatening blood clot just after Christmas 2010. I was initially misdiagnosed at an urgent care facility… my left leg had swollen overnight but most of it disappeared by morning. I was made to feel that I was making a big deal out of nothing, that it was probably just a bruise. I was also told I was at ‘low risk’ for a blood clot. Less than 24 hours later, the same leg swelled up again and became very painful. Figuring something else was going on, I Googled my symptoms and up popped several links to information about DVTs. I went straight to Euclid Hospital and was diagnosed with a massive left leg DVT and embolisms in both lungs. Less than an hour after that, I was in the ICU and being told if I had waited even one more day, I would’ve surely died. Thankfully, I survived. Unfortunately, I am one of the 60% and do suffer from post-thrombotic syndrome. The cause of my clot was never discovered and due to the severity of that first clot, I will be on blood thinners for the rest of my life. But at least I’m still here to tell the tale.

    • The_Beating_Edge_Team

      Thanks for sharing your story. And – congratulations on listening to your body, doing research, getting a second opinion when you needed to and being assertive about your care. betsyRN

    • Solielflora

      I had a similar experience, I was at work and had a real deep and aching pain in my left leg, I left work went to see my Dr. , He could not fit me in, saw a PA and she told me “I was too young for a blood clot (52) that was in January, she did send me for ultra Sound and they said all was clear. Well about April, I had a hard time walking to my desk , from my car-800 steps I counted, I was having instant cladification, only I did not know what it was, May came, my left foot started to go numb, went to urgent care, Dr. said it was sciatica. I told him I had low back pain, it was muskosketal, This was Memorial Day Weekend, I was to have the results that Friday, but being holiday, everyone went home. So He did an MRI on my back, basically did not listen to me sent the results to my Primary Doctor, who told me everything is just fine Monday. At that point, I screamed” that I can not walk”, and that’s when he found no pluses, he got out the ultra sound, my big toe going blue, sent to neurologist, and he told me go straight to hospital, and check in and call your husband. I had a blood clot beneath my left knee, and I had to have a Fem- Pop, 5 1/2 hours of surgery which they take a vein out of your thigh, and surgically by pass the vein. I still have a clot behind my knee, take Plavix, and have scan every year, this is a the fourth year all is good, as they are clear. So I hope that everyone learns that you know what’s going on and what is not right and not let the Doctor tell you something else. Maybe If I had been diagnosed in January, I could have prevented all of this…My leg swells still, cannot sit in chair for more that an hour, elevate leg.

      • Modges

        I was told much the same regarding my age; I was only 41 at the time of my DVT/embolisms. I’m on Warfarin and have to get my INR checked (on average) once a month. Were you diagnosed with post-thrombotic syndrome as well? It took me a long time and many months of throbbing pain, swelling, redness, intense itching, etc. before I was officially diagnosed with PTS.

        • The_Beating_Edge_Team

          Modges – do you also wear support hose – they can be helpful with swelling if you are still getting that with your PTS. betsyRN

          • Modges

            I do now. Oddly, my first doctor didn’t feel they were necessary when I asked him. He seemed to think I could get on fine as usual. Yeah, right!. I went through months of seeing doctors about my lingering symptoms and getting blown off before I was *finally* referred to a Cleveland Clinic vascular specialist who had me fitted for prescription stockings and recommended I wear them daily. Now I see her once a year for a checkup.

      • The_Beating_Edge_Team

        Thank you for sharing your story. People do need to listen to their body and sometimes be persistent to make sure you get the care you need! betsyRN

      • Cheri

        Misdiagnosis should be cause for litigation. You could have died, because doctors are sometimes not willing to take the time and effort to for proper diagnosis. Insurance companies may be at fault too. Doctors are pressured to see so many patients to bring in the almighty dollar. Our medical system and insurance companies need to climb down from their ivory towers and piles of cash to treat patients properly. Lol

  • Debby Carpenter Southwell

    In 2011 I had DVT in left leg & multiple PEs in my lungs. Only symptoms I had seemed to me was an uncontrolled asthma attack. After 3 days finally had this checked and was told about the DVT & PEs. I’ve been on Coumadin since then. Was told will be for life. Had really no risk factors. No birth control pills, non smoker, had not traveled, was active…walking daily. Cannot keep my INR within therapeutic range. If I go longer than 2 – 2 1/2 weeks between getting it checked its high or low significantly. I have never been checked for clotting disorder although have told Dr my mother has essential thrombocytosis, a clotting disorder. I have no idea why I developed these clots back then or if the Coumadin is even the right choice of treatment for me.

    • The_Beating_Edge_Team

      Debby – thanks for your note. It does sound like you could benefit from seeing a specialist in blood clotting. Given your mom had a problem and you are having issues – please see someone locally or we would be happy to help. At the Cleveland Clinic we have a Thrombosis Center – http://my.clevelandclinic.org/heart/departments-centers/thrombosis.aspx . If you want to be evaluated here, you can do it in person or online. betsyRN

    • Deb

      Seek the help of a hematologist. They can do genetic testing to check for clotting disorders and help you manage your INR.

    • The_Beating_Edge_Team

      You may want to get an opinion by a hematologist or blood clotting disorder specialist who can run genetic testing on you as well as test for certain factors. We are having a chat next Thursday on this topic if you want to participate or ask questions. chat.clevelandclinic.org

  • Sharlynné Le Doux

    My son has a 3 foot clot in his left leg…begins behind his knee goes around inner thigh and into his abdominal area. He was on blood thinners for over a year (He is currently in remission from Stage 3 Hodgkins Lymphoma) the clot has not changed but is definitely limiting his life and/or work.
    I have asked but certainly never been answered why they cannot or will not surgically remove it. In this day and technological age why not? It is like living with a time bomb ticking…

    • Deb

      They cannot remove a DVT unless it is at immediate risk of becoming a pulmonary embolism. Using clot busters can cause serious internal bleeding and should only be used when deemed very necessary.

    • The_Beating_Edge_Team

      Sharlynne – I spoke with Dr Park – one of our vascular surgeons and he stated the following:

      If it is a superficial thrombophlebitis and it is symptomatic in the surrounding veins, then removing the vein may relieve pain, but usually these clots are stable, particularly if he has been on anticoagulation for over a year without new events. Usually these superficial clots are removed for pain, not for embolism potential.

      The extension on the abdomen may mean he has extensive deep vein thrombosis or he was treated in the groin or pelvis for lymphoma, and this may be the underlying reason why he has not been able to work/return to baseline lifestyle.

      He is happy to evaluate or to talk to your son – let us know if you want to connect. betsyRN

  • Jobi Mallory

    I am not on “blood thinners” but I am on aspirin therapy(325mg) should I limit my intake of greens also?

    • The_Beating_Edge_Team

      People who are on aspirin therapy generally do not need to limit their diet – but – you should ask your doctor if you are concerned. betsyRN

  • sweet401

    I had a clot that was from my crouch to my ankle.I had no swelling redness or warmness in the leg . No symptoms ..it occurred after I had two stents put in.know I have to take warfarin daily..blood draws weekly..I was too active after surgery is what I was told spent 6 days in hospital.

    • The_Beating_Edge_Team

      That is surprising you had no symptoms. If you do develop symptoms, see a vascular specialist for an evaluation.

      • jan

        I also had no symptoms..

  • Larry Szczepanik

    drop the blood thinners take fish oil, garlic, and vitamin E supplements. One fish oil tablet breaks down the fibrin in blood that produces blood clots. and don’t let a Doctor tell you any different. also, eat right and exercise, and stop smoking

    • The_Beating_Edge_Team

      Larry – unfortunately for people who have a history of blood clots (or for those at risk for future clots), fish oil or aspirin may not enough to protect them against future blood clots, depending on the underlying cause of the blood clot. All patients need to be evaluated to see what the best treatment is for their specific medical history; associated medical conditions; age; medications they are on and any additional risks for stroke or DVT. betsyRN

  • Cheryl

    Does lymphedema and neuropathy in the legs put one at greater risk for DVT? Severe, painful leg cramps in inner part of upper thigh (near groin) have occurred when resting after all day trips up and down stairs, climbing up and down ladder, being on feet all day.

  • 1themecca

    My spouse (very healthy) had a bout of multiple pulmonary embolisms a couple of years ago. Work-up revealed a clotting disorder. Coumadin has been prescribed ever since. Can you tell me if any of the newer anti-coagulants are ever used in clotting disorders?

  • Lee Winkler

    I have having really bad pains in my leg to where it been affecting my walking so I am wondering if it could be a blood clot leg is not warm or swelling just a lot of pain

    • The_Beating_Edge_Team

      You may also have something called Claudication, which is a symptom of peripheral artery disease. It is pains in the legs with walking. I would suggest an evaluation with a vascular specialist. betsyRN http://www.clevelandclinic.org/heartnurse

  • Vegas kris

    I had a DVT that went to my lung. Now I worry when I sit too long. I was on blood thinners for 6 months. It was the worst time of my life now I’m allergic to wheat. They put a vena filter in me and then had troubles getting it out and I had three surgeries to get it out. I was misdiagnosed when I went to the ER two weeks after hysterectomy. They told me it was leftover gas from my surgery. When it was actually a blood clot going to my lung.

    • The_Beating_Edge_Team

      oh my. So sorry for your troubles – hope you are feeling well now. We are having a web chat next Thursday on blood clotting disorders with two of our specialists if you want to participate – chat.clevelandclinic.org

  • Stephanie Croft

    Since 2006 I have suffered over ten DVts three embolisms an a complete block on left kidney I was put on arixtra then back to lovenox bad thing is none of the clots showed the same symptoms. An increase of estrogen long travel surgeries some meds all cause clots so if you have had a clot or someone in your family has be careful most reasons is genetics

    • The_Beating_Edge_Team

      Yes – when you are prone to clots – you need to be aware of things that increase your risk and hopefully avoid or prepare for them. We are having a web chat next week on clotting disorders you may be interested in – chat.clevelandclinic.org

  • Jaffar

    One thing that seems not ever be discussed in these advisories is levothyroxine. One has the impression from the warning one gets from the accompanying paper one receives with refills telling you to stop taking levothyroxine before surgery that it has anticoagulant effects. On the other hand, testosterone has the opposite effect and we know it can cause clots and strokes. Where is all that in this ?

    • The_Beating_Edge_Team

      You can read about levothyroxine at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682461.html#other-information and http://www.rxlist.com/synthroid-drug.htm. Levothyroxine is not an anticoagulant – it is a thyroid medication, however may interact with medications you may have during surgery, therefore, they state “Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).”
      [By sending you the information from other internet sources does not imply any endorsement of the material on their web sites or any association with their operators.] betsyRN

      • Jaffar

        Gee, what medications could levothyroxine possibly interact with while you’re having surgery? Is this another instance of an internet health information resource withholding information because it might upset the user (such as http://www.cancer.gov not telling the user that mesothelioma is invariably fatal)?

  • Jaffar

    Okay, let me put this a little more directly: Isn’t levothyroxine also a form of blood thinner? If not, why do you have to cut back or stop taking it if you’re having surgery?

  • Belinda Waugh

    I have DVT. IN Left leg ave had it going on 13yrs. Drs. Never seen anything as large it is. And will never go away. Have green filter, and take Warfin and at time Levanox injections. My dosage of warfin goes up and down. Dr been said I was a ticking time bomb. :( Birth control pills may of caused it. And yes I’m disabled.

    • The_Beating_Edge_Team

      Belinda – I spoke to Dr. Gomes who is a specialist in blood clots and “hypercoagulable states – he stated the following: “I am not sure what you meant by saying “DVT is going on for 13 years”. We know from clinical studies that, in patients who developed an acute leg DVT, there is a 50% chance that the “clots” will not disappear completely as time goes on. This does not mean that the DVT is still “going on“, but rather that your veins healed (from the acute DVT) without completely dissolving the “clots”, which have now become “old” or “chronic”. These are not “new” or “ongoing clots”, just “scar clots”, if you will. Patients who develop a leg DVT have a high risk of developing a condition called “Post-Thrombotic Syndrome” (PTS), which essentially consists of chronic, intermittent leg pain and/or swelling. This condition may be quite debilitating, and I wonder if this is what’s going on with you. Sometimes, though, there may be other reasons for pain, reasons which may have been wrongly attributed to the “clots”. Symptoms of “PTS” may be prevented and/or relieved by wearing high-grade compression stockings; these must be fitted properly. I can tell you that only a very small minority of patients who had DVT can or should be considered a “ticking time bomb”. Usually, when I hear such labels, they’re inappropriately used 9 out of 10 times. However, obviously I do not know details of your case. You may want to consider a second opinion from a Vascular Medicine specialist.”

      If you want to make an appointment at Cleveland Clinic, we would be happy to see you. Here is information on our Thrombosis Center – http://my.clevelandclinic.org/heart/departments-centers/thrombosis.aspx betsyRN

  • Shirley Small

    I can’t think straight. My 88 year old mom lives at an assisted living community for the last year and loves it. The last few months she has had shortness of breath and dr. found a clot in her lung and chest and started her on caumadin. Last month she had a bad shortness of breath bout and 911 came. She was in hospital a few days for low red blood cells. Her hemoglobin was around 7 ..they gave her blood, steroid shot and went home. They did endoscope and could not find any source of bleeding. The wanted my mom to do colonoscopy–she has dementia and refused to drink the prep. When she is in the hospital she sometimes gets out of control -normally pulling iv’s and any catheters out and saying she is going home. Then once home she is back to her regular self. The plan was to do a blood test every 2 weeks and if she needed blood to take her to hospital. This was June 28th. July 8th I take her into first appt with a hemotologist . My mom was breathing so hard they checked her vitals and her oxygen level was 74 and had high heart rate. The dr. got a wheelchair and took her to emergency room. There they did a SC scan of her chest and now said she has multiple clots in her lungs. Her blood level was at 9. They started heparin drip, gave her steriod for any inflammation etc.. Two days later the doctor told me her hemogloban dropped to 7000 so they can’t give her blood thinners anymore. She recommended I have hospice involved with her place. My mom left yesterday and was feeling great. I now am having a hard time gripping with just not doing anything about her clots. I feel like I am giving up on her. If she felt bad and couldn’t get around that would be different. I keep thinking I should get a 2nd opinion but not sure what kind of a doctor I would go to. Surely there is some kind of blood thinner that is a lower does that could help without bleeding.

  • Chris

    I developed a DVT and PE in my early 20s. I was on blood thinners for 6 months and tested negative for all blood disorders. I’m now 30 and have had many episodes of pain where the DVT was…even taking trips to the ED for ultrasounds. I had no idea PTS even existed. Is there a blood test to diagnose PTS or is it just based on symptoms presented? I’m wondering if that’s my reoccurring problem. It would certainly decrease my worry every time my leg hurts knowing it was that rather than a new clot.

    • The_Beating_Edge_Team

      Chris – I asked Dr. Evans and this is what she had to say – I think it will help you. betsyRN.
      Hi, Chris. Thanks for your question.

      The post-thrombotic syndrome is diagnosed clinically by asking patients about their symptoms and then examining the affected limb. There is no blood test or imaging that diagnoses it. Most commonly we use a score called the Villalta scale for diagnosing PTS. You’re asked to rate your symptoms (leg pain, cramps, heaviness, burning/tingling, and itching), and then your leg is examined for swelling, dilated blood vessels, redness, hardness of the skin, and tenderness on squeezing the calf.

      The symptoms of PTS can come and go from day to day and month to month, so sometimes I tell my patients who’ve had previous DVT to watch and wait for a day or two. If the symptoms are persistent or severe, I have them get checked for recurrent blood clots, but if the leg bothers them for a day and gets better, it’s probably PTS.

      PTS is incredibly common after DVT (up to 50% of DVTs in the thigh or higher), so it’s possible you could have it. It would be reasonable to get checked out by a vascular medicine doctor or hematologist who specializes in DVT and is familiar with PTS.

      • Chris

        Thanks so much! I appreciate the additional information!

  • janEpantz

    Also had embolism…NO symptoms.at all…

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