Swelling in the leg can be a blood clot

Thursday, September 25th, 2014

Priya Rudolph, M.D., PhD“This swelling in my left leg started since a week after I got released from the hospital”, said my 55 year old patient with history of breast cancer. I quickly set her up for an ultrasound test of her leg the same day and she was diagnosed with a blood clot.

This is not an uncommon story. People can develop blood clots in the leg veins when blood flow is slowed for prolonged time. When we walk, the muscles in our legs pump blood back up to the heart and keeps blood flowing. However, when we are sedentary for several days, the blood can pool and cause a clot. This can happen after being on bed rest for a while, such as following a hospital stay, or after a long car ride, or a long flight. Another risk factor for blood clots is obesity because of increased pressure in the veins in pelvis and legs. Certain medications such as oral contraceptive pills or estrogen pills can also increase one’s risk of developing blood clots. Pregnant women can develop blood clots, particularly if they have an inherited risk of blood clots. Smoking, besides causing multiple other health related problems, can also increase risk of blood clots. Blood clots are not uncommon in patients with cancer and this may be triggered by the cancer itself or due to cancer treatments. Certain other illnesses in the body such as heart failure and inflammatory bowel disease can also increase one’s risk of developing blood clots.

Broadly speaking, blood clots can be due to some of the risk factors listed above or they can be due to an inherited risk for clotting. When I see a patient with a blood clot, I run a battery of blood tests that help me detect some of these inherited conditions as well as other causes of blood clots. This also helps me to determine duration of treatment with blood thinners.

Blood clots can occur anywhere in the body. Most common site for blood clots is in the veins in legs and this typically causes leg cramps or severe pain in the leg. It is often associated with swelling (edema) and sometimes redness in the leg. If blood clots travel to the arteries in the lungs they can cause chest pain and/or difficulty breathing. In some cases, this can be life threatening.

There are many blood thinners available today to treat as well prevent blood clots. These can be administered as pills, injections or intravenous medicines. Please go to the emergency room or notify your doctor if you notice any symptoms suggestive of a blood clot so that appropriate treatment can be instituted immediately.

While we cannot change inherited risk for blood clots, many life style changes can reduce one’s risk for developing blood clots. Losing weight and smoking cessation are two such modifiable risk factors and significantly reduce ones risk of developing blood clots.

Blood clots are preventable and treatable. Don’t ignore symptoms of blood clots and seek medical attention immediately if you think you may be having a blood clot.

Priya Rudolph, MD, PhD

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