What Every Woman Needs to Know About Blood Clots

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On the Mend

What Every Woman Needs to Know About Blood Clots

by Varci Vartanian - Reproduced with Permission – Originally Published in the Daily Muse April 8, 2012

What every women should knowKate, a 28-year-old development professional, was uploading snapshots of Mai Tais and Maui sunsets from her Hawaiian honeymoon when she noticed a pain in her calf that felt like a pulled muscle. At night, the pain was so intense that it woke her up, so she went to an orthopedic surgeon who ordered a scan.

The test didn’t show any issues, so she forgot about it, until seven months later, when the newlyweds hopped a plane to San Francisco. On the return layover, Kate exited the plane, felt dizzy, and passed out in the terminal. The alarmed couple rented a car and drove back home to North Carolina, where she saw a doctor again. He chalked it up to dehydration.

Then Kate started experiencing something new on her daily five-mile walks: “I was kind of short of breath. Since it was my first summer in North Carolina, I thought it was allergies or maybe that I was out of shape—so I would go extra hard on the elliptical machine.” She didn’t share her symptom with anyone and soon became preoccupied with packing for a family trip to Alaska and Seattle.

As she waved hello to Starbucks’ stomping grounds from the Space Needle, Kate was completely unaware of the killer in her right calf. A massive blood clot, or deep vein thrombosis (DVT), had formed in her lower right leg and was releasing smaller clots that were traveling to her lungs.

These blood clots in the lungs, called pulmonary emboli (PE), “can be life-threatening and in 10-15% of cases, cause sudden death,” says Dr. Jack Ansell, MD, hematologist and chairman of the Department of Medicine at Lenox Hill Hospital in New York and member of the National Blood Clot Alliance’s Medical Advisory Board. “The first sign of a PE can be death.”

As the trip progressed, Kate had an increasingly difficult time catching her breath. She couldn’t shake the feeling “that something was wrong,” but boarded the plane with a pack of M&M’s and told herself everything would be OK.

Mid-flight, she got up to use the bathroom and collapsed in the middle of the aisle. A group of firemen on board gave her oxygen, and upon landing, an ambulance whisked her to an Atlanta ER where she was diagnosed with dehydration and vasovagal reaction (a fainting episode). She immediately flew back to North Carolina and scheduled an urgent doctor visit. As she prepped for her appointment, she collapsed again after climbing the stairs.

“I called 911, and the [paramedics] didn’t think anything major had happened,” she recalls. “They said, ‘wait until your husband gets home and he can take you to the doctor.’”

Luckily for Kate, a mother’s instinct was on her side. Her mom (a nurse) suggested that a blood clot might explain Kate’s mystery malady. Her doctor ordered a V-Q scan (a specialized lung test), and found multiple PEs in both lungs. Kate—a healthy young woman whose only risk factors were a series of flights longer than five hours and the daily birth control pill she popped—was in danger of having a heart attack.

Although Dr. Ansell states that the actual frequency of DVTs is low in young people, he emphasizes that it’s essential to know about the risk. “This should not be called an epidemic, but about 100,000 people die each year as a result and there are upwards of 500,000-600,000 cases per year.”

Take a lesson from Kate’s story, and read on for what you need to know.

Acquaint Yourself With the Symptoms

Kate was lucky to escape with her life, but knowing the warning signs could have gotten her more immediate medical attention. Shortness of breath, chest pain (particularly with deep breathing), coughing up blood, persistent leg pain, or redness, swelling, or warmth in your lower legs (usually one-sided) can all be indications of a blood clot in the legs or lungs, and should never be ignored.

And, give yourself a break already. “Women tend to beat themselves up about losing weight,” she says. “But, if you’re short of breath, it may not mean you’re out of shape. Know the signs and symptoms—you are your own best advocate.”

Get to Know Your Meds (and Your Family History)

Using estrogen-based birth control (pills, patches, and rings) comes with a risk of blood clots, though it’s relatively small. “The overwhelming majority of women on birth control pills do not have problems,” says Ansell.

But, it’s important to note that smoking, being obese, or having a family history of clotting disorders while you’re taking estrogen can all increase the risk.

Check your family tree for clotting disorders before your next appointment for hormonal birth control—and communicate the findings with your doctor. The most common inherited disorder leading to blood clots is Factor V Leiden, which is typically suspected in “individuals who develop blood clots at a young age, who are white with European ancestry, have a family history of clots, or have blood clots in unusual sites,” says Ansell.

If you’re already on estrogen-based birth control, burn the list of DVT and PE symptoms into your brain. And if you feel strongly that something is amiss—trust your instincts and see your doctor.

Wiggle Your Way Across the Ocean

Those warnings you see in the back of airline magazines? They do warrant a few seconds of your attention. “Individuals who undertake long distance air travel (greater than five hours) and are relatively immobile have a slightly greater chance of developing a clot,” says Ansell. And, the possibility of travel-related DVT is amplified somewhat with pre-existing factors (like taking estrogen-containing birth control, pregnancy, or obesity)—however, it’s important to note that the overall risk of clotting with air travel still remains small.

Even so, if you’re traveling internationally or cross-country, it’s imperative to get out of your seat every hour and move. “Get in the habit of fidgeting when you’re sitting,” says Ansell. Point your toes downward and upward, make circles, and heck, even try spelling out the alphabet. The key is to keep the blood flowing.

And, although being well-hydrated (a.k.a. asking the kind flight attendant for ice water instead of extra ice for your vodka cranberry) is never a bad idea—there is no definitive evidence to show that dehydration increases DVT risk. Pushing fluids might, however, push you to get up more frequently to use the facilities, and reduce your risk that way.

While you don’t need to be overwhelmingly alarmed about your blood clot risk, you should definitely be aware. “The bad news is that we’re talking about 100,000 deaths per year from blood clots,” says Alan P. Brownstein, MPH, CEO of The National Blood Clot Alliance. “But the good news is that most of them can be prevented.”

Varci VartanianAbout the Author

Varci Vartanian is a jack (er, Jill) of all trades. After a successful career in healthcare, she traded her lab coat for her current position as chief temper tantrum tamer/play date consultant for her two-year-old. She also enjoys writing short stories, freelance magazine work, and carbohydrates.



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  • Van meeteren Rebekka

    what to Know I have a blood clot in my lung One night had a cramp in my left side went to bed could not turn over or sit up yelled got help jerked me up and we went to Hospital ones there i got terrible pain my heart stopped four times after many a test like m r i scan,s and more they found a blood cloth in my left lung I am now on warfarin for the rest of my life going to labb some times 3x a week I would like to know how or when does that blood clot dessolves or leave the lung? I have heard that often they might brake in to small pieces and make more clot,s so far Doctors have been unable to identify where the blood clot,s came from;however my left foot ,ankle and leg below the knee are swollen specially my ffot right leg is fine Can you tell me more? How can the clot in my long dissapear?

  • Christy

    Would it be useful to ask for a d-dimer if you suspect a DVT?

  • Judy

    I’ve had numerous DVTs and P Es I finally was diagnosed with APS. I threw the clots to both lungs after a very active day riding horses. I am not overweight So please beware it does not necessarily happen when you are sedentary. I went to bed on a Friday woke up in the hospital on a Tuesday . My family could’nt wake me up, that episode was a PE one in each lung After 3episodes of PEs and 4 episodes of DVTs the only thing I can say is you just never know….

  • Lolita

    This is not uncommon in young people. My daughter who was 23 at the time had a blood clot in her leg that traveled to her lungs. I know of another young lady and man that both died from blood clots! There are symptoms and i believe that should be a standard testing for blood clots when you present with certain symptoms. Shortness of breath, pain in the chest or pain in the lower limbs. We had to wait in the waiting room of the ER after her doctor told us to go there because she may have a PE, then we had to wait 15 min!! They told us our daughter was a ticking time bomb it could have been 2 hours or 24 hours but she would have died right on the spot and there was nothing we could do about it! More research and better screening has to be done.

  • http://www.liveholly.wordpress.com Holly

    Great article – awareness is definitely the key! So many people are unaware that DVTs and PEs can come at any point in life and to anybody. I had 13 clots in both lungs in May 2012 with no major risk factor and have suffered another clot in my right lung 8 weeks ago. I am now on life long anti coagulants. They have done lots of tests for blood disorders all negative. More research definitely has to be done to provide more answers. The doctor said if i hadnt have gone in when i did the first time round I would of 100% died in 7 days because the main clot was nearly completely blocking the blood flow to my heart.

  • http://www.ppahs.org Michael Wong

    Thank you so much for this article highlighting the dangers posed by blood clots and what every woman needs to know about them. This risk increases significantly for pregnant women. “For pregnant women, the risks of VTE is 4-5 times higher than women who are not pregnant,” says Dr. Andra James (Professor of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, University of Virginia School of Medicine). “Moreover, this risk is at least twice as much following cesarean delivery.” For more on this and the safety checklist that is being developed for women following cesarean and vaginal delivery, please see http://ppahs.org/2013/05/02/preventing-death-following-cesarean-delivery/

  • Ana Franco

    Read this article…great info. Like others who have shared their stories, I have had issues with blood clots also. I got my first blood clot when I was 29. I was diagnosed with DVT after dealing with a horrible pain in my right calf for about 4 months. The first time my doctor ordered a scan and they found nothing. Two months later I went into the ER because I couldn’t sleep through the night anymore and I couldn’t even stand at my sink and wash dishes. I had to rest it on a chair. So this time, they found a blood clot. I spent 3 days in the hospital and they told me the only way I could be released was if I was willing to have someone inject me or inject myself with lovenox. Anyway, my doctor couldn’t understand why at my age I was getting blood clots. He had me see a hematologist and they ordered all kinds of blood tests. I was tested for this gene mutation called MTHFR which I tested positive for. Basically, I have this genetic mutation which causes my blood to be too thick so I’ll be on blood thinners for life. Just last year I got another clot….same spot. I had moved out of state and had to change doctors and get back on my warfarin sodium. So, now my new doc says I cannot stop taking my blood thinners or I’ll clot again….scary stuff and its nothing to mess around with. I’m lucky that my situation wasn’t worse.

  • Mark

    Ice and cold in this article, write about that ice and cold water to help with hemorrhoids.

  • Tina

    Don’t count on the D-dimer, mine came back negative when I had DVT and PE. False negative, doctors believed it and that almost killed me.

  • April Lea

    I too was diagnosed with DVT at 40 years old. I had started the week with a pain in my upper thigh. I chalked it up to a pulled muscle. My coworker even joked that I may have a blood clot and I laughed it off. The second day it was getting worse and felt warm. I tried to call a family dr and was told just go to the ER as they wouldn’t see me for those symptoms. My husband looked at the area when he came home from work and was shocked to find what he said felt like a pencil inside my thigh. Even at the hospital they first wanted to say it was probably just superficial. That is until the ultrasound tech found otherwise. I went home and had to have my husband inject me twice a day with lovenox, and was on warfarin. A specialist then switched me to xarelto and discovered that I had factor v Leiden, as well as I am also protein s deficient. I will now be on thinners for te rest of my life. The good news is my 23 year old daughter has now been tested and was positive for both, but this could have been life threatening for her as she was on birth control. My niece also has been diagnosed and has now been able to have her first child after two miscarriages. We were unaware this ran in our family, or that it can cause miscarriages. Please learn the symptoms.

  • Jordan

    A few weeks ago I was hospitalized for acute PE caused by a massive blood clot in my leg after foot surgery. I am only 23 and healthy. It can happen to anyone, really. Yes, the surgery is what they suspect caused the blood clot, but please don’t ignore the symptoms even if you’re “not at risk”. I ignored them for days and was told I was very, very lucky I came to the hospital when I did. I had a very sore feeling in my leg that was unlike the pain I had while healing (obviously surgery hurts, but this was a new, dull pain that felt like a muscle pull). I started becoming short of breath and felt like I was beginning to get bronchitis when breathing. Then, the muscle pain in my chest and back started. It was painful to lay down or breathe because my muscles felt torn and even spasmed on me a few times. The muscle pain got worse (I was told it was lack of oxygen to my muscles causing this pain – it is like pulled muscles but very intense and for really no reason. This is when I should have gone to the hospital). Then, I got up to go to the bathroom a day later and my heart started pounding. I couldn’t breathe. I should have gone then but thought I was having a panic attack from the pain in my muscles. Even relaxing and taking deep breaths my heart rate would not go down. I finally went to the hospital with a heart rate of 160 and an oxygen count of 83. I was hospitalized for 5 days. Do not be me. Do not be stupid. If you are having unusual pain in your leg that moves to your chest, intense muscle pain accompanied by shortness of breath, go to the ER. They knew exactly what was up and rushed me back immediately. I very, very likely could have died. I’m lucky I’m young and my heart could handle it. I was told the blood clots were like “buckshot” to my lungs. I am now on blood thinners and have a normal expectancy of life, but please don’t risk it.

  • Melissa K

    I’m 46 and suspected I had a DVT when I developed pain in my calf a few days after surgery. It was confirmed yesterday by ultrasound. If anyone else has just been diagnosed with DVT and has been told little more than, “You have a blood clot. You might die. I’ll call in some blood thinners to your pharmacy,” I recommend watching the patient webinar ClotConnect on YouTube. Don’t skip to part 3 or 4–after the first two or three screens of stuff you probably already know, the thing is packed with info and answers to your most specific questions, including some you didn’t know you had. For example, I was relieved to hear that calf DVTs are less dangerous than thigh DVTs (still dangerous, but less so). Here’s another example: It hadn’t occurred to me not to fly. The presenter recommends not flying for 4 weeks after diagnosis, until the heparin/warfarin has time to do its work, but admits it’s still unclear whether flying with a DVT increases the risk of dislodging a clot. Anyway, I hope the info in the webinar is as helpful to someone else as it has been to me.

  • Barbara Kornblau

    Melissa, you can see the most up-to-date information from the video of our live 4 hour workshop, Stop The Clot Forum that was held this past November in Boston. It answers all of your questions and one of the speakers is Andra James, an international expert who spoke on Women and Blood Clots. You can watch it here http://www.stoptheclot.org/news/stop-the-clot-forum-boston-2013.htm

  • Donald

    I am in a hospital in Tokyo right now. I was diagnosed with PE on Jan 17 and admitted immediately.
    An echo exam on Jan 16 showed no sign of clots in my legs but an enlarged right ventricle.
    A CT Angiography on morning of the 17th, showed both aorta and pulmonary arteries covered in clots.
    Too many to count according to my cardiologist. IV Heparin treatment began immediately. Doctors were baffled
    by lack of clots in the legs and therefore of the genesis of the clots in the heart. I have suffered form UC for 30 years and it was active last fall with bleeding. they believe the clotting began there. Shortness of breath was my only symptom and like others I first thought I was just out of shape. Until one day I walked up a small hill near my home and had to gasp for air as I reached the top. After a week on heparin I developed HIT–which is why I am still in the hospital with a right leg now filled with clots..

  • Ayla Becerra

    Four months ago I hurt my knee really bad for a second time and I noticed that after those months the bruises on my knee are still there. I developed a pain on my thigh. I fear that I may have had a dvt on that thigh and that it has spread causing pain my body but only on the veins. I also had the same “muscle cramp” pain as Kate but on that upper thigh on the same leg I hurt my knee. My mother massaged it and it hurt a lot the pain still stayed and traveled to my calf and I started getting bruises which haven’t gone away to this day. this has been a month and the symptoms just worsen. It feels like a pinching/throbbing on certain parts of my arms and legs now. My veins are very visible and my body is tender. I have many bruises on my legs and arms and I have occasional pain on the right inside of my rib cage and sharp pain on the left of my chest (it feels like sharp stabs at my heart). I have also noticed that I have shortness of breath and odd pain on the right side of my head (like pulsing almost like a migrane but last for a short while) I have been having the headaches and heart pain constantly. I went to see my doctor but all he did was give me pain killers that just didn’t work. I did a blood test (that was extremely painful afterwards that caused the pain I have now on my arms) and I came out perfectly fine the doctor doesn’t seem concerned and tells me that it may be a cause of stress but my body has never reacted this way. He told me to wait another to week to see if the pain persists. I feel like something is severely wrong and I’m very afraid. The symptoms just get worse along with the pain as time passes. I’m only 19 years old and I understand that its not common for someone of my age to get a blood clot and I might be over exaggerating but this is not normal. I’m tired of feeling like I’m a nut case with my doctor and him not putting importance in my symptoms. I don’t know if I should go to the ER, I feel like they might tell me the same thing as my doctor.

    • Emma

      .As u probably already know u r showing a lot of the symtoms of blood clots, travelling 2 ur lungs and heart.I’m not a dr but I have recently been diagnosed with a blood clot myself.my leg had swollen up and I went straight 2 A & E and was put on anticoagulants immediately.I got an ultrasound scan and the first one was clear.They offered a second scan a week later which I went for and it showed a clot.It dozn’t mattet how old u r.Go 2 hospital asap and xplain all ur symtoms and that u had a knee injury.Don’t worry about it being nothing .somerhing is causing these symptoms and if ithe sooner u get chkd the better..I dont want 2 over worry u but its a very severe condition.hopefully it won’t b that but there r treatments depending on where it is, the size and severity of it. Go 4 that 2nd opinion at A & E.Thats what there here 4.goodluck hen and godbless x

  • Ayla Becerra

    I also forgot to say that I sit for large amounts of time since I work at the library in the evenings and go to school in the morning. I don’t know if this can also be a symptom for a blood clot but lately I’ve been having odd stomach aches that only last for a few seconds just like the heart pains.

  • robin

    I am 42 yrs old one year ago my left hand swelled I went to er they found a large blood clot in my bracial vain they put me on lovanox injections and 11.25 mg of warfin shortly after that they ran every blood test every scan possible to find cause but only found more clots total of 4 one in jugular one in bracial and 2 in abdomin all on left side and still no answer to what is causing this. The warfin made me feel very awful in alot of ways against hemotoligst better judgement I took myself off blood thinners and just looking out if I feel any signs or symptoms.

  • Yvonne

    You can not stop. You need to keep taking call your doctor and tell him your problem. You may be able to change medication. You are playing with fire and you will lose.

  • robin

    Thank u for your reply unfortunately its the only thinner covered by my insurance the others are up their in price . Guess you could say this is ware my faith steps in. :)

    • cw

      Your doctor may be able to petition your insurance company on your behalf to try to obtain a different medication, and also with more affordable pricing if the others are very high priced. It’s an appeal, and should take 30 days or less to have the doc’s request reviewed and receive a response from the insurance co. It can be worth trying, and is sometimes successful for getting the drug one needs as well as different pricing than one’s drug formulary indicates. Good luck. I know this is an older post, but thought I’d still reply. Definitely, you need to continue on medication for this problem. Go back to your doc, please, and explain your issues with it.

  • Jasmine

    My left calf muscle and leg is much bigger than my right. This happened years ago when I developed a massive ulcer in my calf muscle which over a year to heal and in the end, they thought it was caused by a white tip spider. But then, because of the obvious swelling of my left leg and my left calf in particular I was sent to a vascular surgery place where they could see my veins were not pushing my blood properly so they stripped some veins in my leg. That however, made my leg even more bigger and then no doctor could work out why so they put it down to lymphodema and then that was that. I’m 24 and healthy and . And my leg and calf is swollen. I’m laying in bed now reading this because my left calf is experiencing a weird pain inside, that I’ve never felt. It’s only when I move it around. When it’s resting I don’t feel it as much. I’ve been in and out of specialist and doctors since 2008 trying to figure my leg out. Should I go to the ER and explain this or will I get turned away?

  • Jasmine

    And yes… I did indeed get turned away :(

  • Tina

    What about pain that pulses in my left side of neck, comes and goes, but is sharp and has disturbed my sleep?

  • Holley

    Im a 39 year female, who just happens to be in the hospital from bloodclots being in both lungs. I’ve also got them behind my left knee cap. Yes im scared..of dieing….I want them to go away. Will they? Will i be ok? Im taking blood thinners

  • patty

    I so wish I would have seen this a month or two ago.
    My mother in law just randomly died in her sleep because of a blood clot.
    Now reading this article so makes me think of all the aches she used to talk about.
    God bless rip mom (colleen)

  • Julie Jones

    I am 53 female, I have been getting a lot of cramp in my right calf at night and sometimes in my thigh and i get short of breath when i get up to use the bathroom and now my thigh and calf feel bruised when i walk and i do tend to sit on my leg most of the time … Please can any one help. many thanks Julie

  • Julie Jones

    Oh and i also get tingling in my hands and numbness in my arms and i cant raise them … Julie

  • linda

    In 2004 I was 42 and woke up with a purple left arm. The short story. Was a clot in my biracial and another in my biracial/jugular. I am pretty stable on 5 mg warfarin. Recently I have been fluctuating and tonight my mid thigh pain woke me up. Dropped blood today for protime cause my neck has been hurting for 3 dayss.

  • linda

    Stupid auto correct -bracial

  • robin

    Well as I posted on feb 23rd I had stopped taking my blood thinners against my doctors better judgement well since this all started my left side gets weaker and weaker welll come to find out I have had a stroke and didnt know it this clotting thing is really a ugly thing your world changes over nite and it doesnt matter your age its feels like I just need to enjoy life with my kids and grand daughters because at this rate im not promised tommarrow. Each day I wake up and thank my god he allowed me one more day with all my babies. I thank you my god for keeping me in ur covenant …….