2. What Is Deep Vein Thrombosis (DVT)? DVT is a blood clot that forms in a vein deep in the body Most often occurs in the deep veins of the legs, either above the knee or below it The blood clot or part of it can break free (called embolism) and become lodged in the blood vessels of the lung, causing pulmonary embolism (PE)

3. DVT: A National Public Health Crisis 1 Up to 2 million people in the United States suffer from DVT every year 2,3 Complications of DVT, such as PE, kill up to 200,000 people each year, more people than AIDS and breast cancer combined 2-6 Some Causes of Death in the US Annual No. of Deaths PE Up to 200,000 AIDS 16,371 Breast cancer 40,580 1. American Public Health Association. Available at: http://www.apha.org/news/press/2003/DVT_whitepaper.pdf. 2. Gerotziafas GT. Curr Opin Pulm Med. 2004;10:356-365. 3. Anderson FA Jr. Arch Intern Med. 1991;151:933-938. 4. Centers for Disease Control. Available at: http://www.cdc.gov. 5. American Cancer Society. Available at: http://www.cancer.org. 6. Bick RL. Clin Appl Thromb Hemost. 1999;5:2-9.

4. Some Risk Factors for DVT 1 Illness or injury that causes prolonged immobility increases the risk of a DVT Age >40 years (VTE risk increases with advancing age) Birth control pills and hormone replacement therapy Cancer and its treatment Major surgery (example: abdomen, pelvis, or hip or knee replacement) Obesity Previous DVT or PE A family history of blood clots 7 Certain heart problems Varicose veins Faulty blood clotting is an uncommon cause — an example is an inherited condition that causes the blood to clot more easily than usual (factor V Leiden) 1. American Public Health Association. Available at: http://www.apha.org/news/press/2003/DVT_whitepaper.pdf. 7. Geerts WH. Chest. 2004;126(suppl):338S-400S. 8. Kibel AS. J Urol. 1995;153:1763-1774. The more risk factors a person has, the greater the chances may be of developing DVT 8

5. Symptoms of DVT and PE 1 1. American Public Health Association. Available at: http://www.apha.org/news/press/2003/DVT_whitepaper.pdf. DVT Swelling of the leg Pain or tenderness in the leg; the pain is usually in 1 leg and may only be present when standing or walking Skin that is warm to the touch in the leg Red or discolored skin PE Unexplained shortness of breath Chest pain and/or palpitations Anxiety and/or sweating Coughing/coughing up blood Fatigue and/or fainting Not all people with DVT have signs or symptoms 1

6. Diagnosing DVT Diagnosis may begin by confirming that you have risk factors for DVT Your doctor will ask about your general health, previous illnesses, including past episodes of DVT, the medicines you are taking, and your recent activities He or she will conduct a physical examination If DVT is suspected, additional tests will be needed to confirm the diagnosis

7. Treating DVT Treatment of DVT can help reduce the risk of complications, such as PE The main goals in treating DVT are to help: –Stop the clot from getting larger –Reduce the chance of having another clot develop –Prevent the clot from breaking off in your vein and moving to your lungs

8. Treating DVT Drugs –Anticoagulants (blood thinners) –Thrombolytic agents (drugs used to dissolve blood clots) Practical measures –Elevate the affected leg whenever possible –Apply heat to relieve pain and reduce swelling –Wear compression stockings or support hose –Avoid long periods of immobility

9. Preventing DVT The good news is that DVT may be prevented If you are planning to have surgery or an extended hospital stay, ask your doctor what you can do to reduce your risk of DVT. Some examples could be: –Getting out of bed and moving around as soon as possible after having surgery or being ill –Taking medicines to prevent clots during certain illnesses in the hospital or surgery, as directed by your doctor

10. Summary DVT is a blood clot that forms in a vein deep in the body The clot or part of it may break off and travel to the lung Many conditions may increase your risk for deep vein clots The more risk factors a person has, the greater the chances may be of developing DVT Not all people with DVT have symptoms The main goals in treating DVT are to stop the clot from getting bigger, to decrease your chance of having another clot, and to stop the clot from breaking off in your vein and moving to your lungs Medicines are used to treat DVT and help reduce the risk of DVT

11. Talk to Your Doctor It’s important to share your concerns about cardiovascular health and DVT with your doctor Ask questions and be prepared to provide accurate information about your lifestyle, diet, exercise routine, and medications Anyone who’s off his or her feet due to illness, injury, or surgery, or who has ever had a blood clot, should talk to a doctor about DVT and its prevention

12. Remember… DVT doesn't have to happen to you  it may be prevented DVT may be treated if it does happen For more information, visit www.preventdvt.org, www.dvt.net, or call 1-888-DVT-NET-1

13. Additional Resources American Heart Association (AHA) www.americanheart.org American Obesity Association (AOA) www.obesity.org National Heart, Lung, and Blood Institute (NHLBI) www.nhlbi.nih.gov Society for Vascular Medicine and Biology (SVMB) www.svmb.org Spotlight Health www.spotlighthealth.com University of Massachusetts Medical School www.dvt.org

14. 1. American Public Health Association. Deep-vein thrombosis: advancing awareness to protect lives. White paper. Public Health Leadership Conference on Deep-Vein Thrombosis, Washington, DC; February 20, 2003. Available at: http://www.apha.org/news/press/2003/DVT_whitepaper.pdf. Accessed November 9, 2004. 2. Gerotziafas GT, Samama MM. Prophylaxis of venous thromboembolism in medical patients. Curr Opin Pulm Med. 2004;10:356-365. 3. Anderson FA Jr, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT Study. Arch Intern Med. 1991;151:933-938. 4. Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in the United States, 2002. HIV/AIDS Surveillance Report, Vol.14. Available at: http://www.cdc.gov/hiv/stats/hasr1402.htm. Accessed November 9, 2004. 5. American Cancer Society. Breast Cancer Facts & Figures 2003-2004. Available at: http://www.cancer.org/docroot/STT/content/STT_1x_Breast_Cancer_Facts_Figures_2003-2004.asp. Accessed November 9, 2004. 6. Bick RL. Therapy for venous thrombosis: guidelines for a competent and cost-effective approach. Clin Appl Thromb Hemost. 1999;5:2-9. 7. Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(suppl):338S-400S. 8. Kibel AS, Loughlin KR. Pathogenesis and prophylaxis of postoperative thromboembolic disease in urological pelvic surgery. J Urol. 1995;153:1763-1774. [CODE] References LOV-SL-18537-1