By Dr Ananya Mandal, MD
A blood clot or thrombus can occur in both the arterial and venous blood vessels. A part of a clot can also break away form the main clot and travel to the lung or brain where it causes another blockage or embolism. The condition may be treated with anticoagulants or blood thinners, which decrease the clot’s ability to cause blockage as well as preventing its growth. Examples of the most commonly used anticoagulants include heparin and warfarin.
Duration of therapy
The duration of therapy with blood thinners depends on various factors such as:
- Size and location of the clot
- Presence of risk factors associated with the clot formation
- Presence of risk factors that can lead to recurrence of clots
If the risk of recurrence is low, then short-term treatment for 3 months is often sufficient. However, if the risk for developing another clot is high, long-term treatment of more than 3 months may be necessary and often lasts for several years or even for the patient’s lifetime.
Venothromboembolism (VTE) and cancer
Several cancers raise the risk of thrombosis because tumors can produce substances that activate coagulation or the blood clotting system. In addition, several chemotherapy drugs used to treat cancers also raise the risk of VTE. For example, tamoxifen used in breast cancer therapy raises the risk of clots.
Thrombosis and pulmonary hypertension
A blood clot that arises in a vessel of the lung or pulmonary embolism (PE) can increase the resistance to blood flow in the pulmonary vessels, leading to pulmonary hypertension. This can eventually lead to symptoms such as shortness of breath, decreased ability to exercise and chest discomfort.
Pain persistence after DVT
Blood thinners can prevent the recurrence or growth of blood clots but cannot dissolve them. However, in most cases, the body breaks down blood clots, which gradually disappear. Most patients treated with blood thinners for deep vein thrombosis or PE recover within several weeks to months of treatment, without any complications. However, some clots get converted into scar tissue which can damage the valves present in veins. This can cause valve dysfunction, a condition called chronic venous insufficiency or post thrombotic syndrome.
Symptoms of post thrombotic syndrome include long term swelling, chronic pain, pressure, heaviness, tightness and changes in the skin such as dryness, hardening, pigmentation, ulcer formation or itching.
Exercise after thrombosis
Doctor advise patients about which type and amount of exercise is considered safe, but generally exercises such as walking or swimming are considered beneficial. Exercise can increase circulation, reduce inflammation and improve a patient’s sense of wellbeing. In cases of PE, exercise can help to improve lung function.
Reviewed by Sally Robertson, BSc