TABLE OF CONTENTS
100 Questions and Answers
About Deep Vein Thrombosis and Pulmonary Embolism
Part 1: The Basics
- What is blood?
- What is the purpose of blood vessels?
- How and why does blood clot?
- What is deep vein thrombosis (DVT)?
- How common is DVT?
- Where does DVT occur?
Part 2: Diagnosis and Symptoms
- What are the symptoms of DVT?
- What is the difference between DVT and superficial vein thrombosis or superficial thrombophlebitis?
- How is DVT diagnosed?
- What are the consequences of DVT?
- What is the post-phlebitic or post-thrombotic syndrome?
- What is pulmonary embolism (PE)?
- What are the symptoms of PE?
- How is PE diagnosed?
Part 3: Initial Treatment
- What are the goals of treatment of DVT?
- What is the initial treatment of DVT?
- What is heparin?
- How does heparin work?
- What is the difference between heparin and low-molecular-weight heparin (LMWH)?
- How is the dose of heparin or LMWH determined?
- What is the activated partial thromboplastin time (aPTT)?
- How does fondaparinux work?
- What is the initial treatment of PE?
- What are the side effects of standard heparin or LMWH?
- What is warfarin?
- How does warfarin work?
- Why is warfarin not used for initial treatment of DVT or PE?
- What is a vena caval filter?
- What if the DVT or PE is limb- or life-threatening?
Part 4: Long-term Treatment with Warfarin
- How long will I require treatment with warfarin?
- How long can warfarin be taken?
- What are the risks of treatment with warfarin?
- Why are frequent blood tests required?
- What is the prothrombin time (PT) test?
- Where do I go to have my PT or INR measured?
- Can I monitor my own INR at home?
- What is vitamin K and what does it do?
- Why must I pay attention to my intake of vitamin K while taking warfarin?
- What foods have vitamin K in them?
- While taking warfarin, is wine, beer or liquor allowed?
- What about dietary supplements and herbal medications while taking warfarin?
- How can the risks of bleeding with warfarin be reduced without increasing the risk of a clot?
- Is there an alternative to warfarin for long-term treatment or prevention of DVT and PE?
Part 5: Risk Factors
- What conditions increase the likelihood of blood clots?
- What is the factor V Leiden?
- What is the prothrombin gene mutation?
- What is the antiphospholipid syndrome?
- Can children get blood clots?
Part 6: Pregnancy
- Does pregnancy cause blood clots?
- Why is warfarin unsafe during pregnancy?
- Why is heparin or low-molecular-weight heparin (LMWH) considered safe?
- How are blood clots treated during pregnancy?
- How are blood clots prevented during pregnancy?
- What precautions are taken at the time of delivery?
- When are anticoagulants restarted after delivery?
- Are anticoagulants safe to take while breastfeeding?
Part 7: Menstruation and Birth Control
- Is it true that birth control pills cause blood clots?
- Can a woman take birth control pills if she has had a blood clot in the past?
- What if a woman has thrombophilia but has never had a blood clot?
- Can anticoagulation cause heavy periods or other gynecological problems?
- How can heavy menstrual bleeding be managed?
Part 8: Menopause and Hormone Therapy
- Does estrogen cause blood clots?
- Can a woman who has had a blood clot in the past take estrogen?
Part 9: Medical Problems
- What if cancer is present?
- What if kidney failure is present?
- What if heart disease is present?
- What if diabetes is present?
- What if liver disease is present?
- What if high blood pressure is present?
Part 10: Surgery and Trauma
- What happens if I am on warfarin and I have to have surgery?
- What if I am taking warfarin and I have to have emergency surgery or I am injured?
- How will I be protected from blood clots at the time of surgery or injury if I am not taking warfarin?
Part 11: Travel
- What measures can be taken to prevent blood clots during travel?
- How is anticoagulation managed during travel?
Part 12: Activity, Sports and Recreation
- What limitations do I have?
- May I dive?
- May I hike or climb?
Part 13: Complications
- Can DVT cause permanent damage?
- How can the post-phlebitic or post-thrombotic syndrome be prevented?
- What are the consequences of PE?
- Can PE cause permanent damage?
- How is swelling treated?
- How is pain treated?
- How are leg ulcers treated?
- How are recurrent blood clots treated?
Part 14: Prevention of Recurrent Clots
- What is the chance of my having another DVT or PE?
- Are there foods or medications that should be avoided?
- If I am not taking anticoagulants are there special precautions I should take?
- Does aspirin prevent blood clots?
Part 15: Family and Genetic Issues
- If I have had a blood clot, do I need to be tested for thrombophilia?
- If I learn that I have an inherited thrombophilia, what should I tell my family members?
- If I have a family member who has had a blood clot or thrombophilia, but I have never had a blood clot, what are my risks?
- If I have a family member who has had a blood clot or thrombophilia, but I have never had a blood clot, should I be tested for thrombophilia?
Part 16: Miscellaneous
- Do I need to wear a medical identification bracelet or necklace?
- What does insurance usually pay for?
- Who treats DVT and PE?
- Where can I find an expert in the field?
- Where can I go for additional information?