On occasion, your husband has complained of a cramp in his leg. You know from experience that this type of pain is intense, but today you are busy and really just want to tell him to stop complaining. After all, most people have experienced a leg cramp, and it typically goes away quickly. A while later he notices a red spot on the same leg and shows it to you. You wonder, can this be serious? You try to ignore your concern because you have a deadline at work and a trip to the ER will take up hours of your time. An hour later you decide to check his leg again and notice that the red area is also warm. The ER visit is now inevitable.
The signs and symptoms of a blood clot can be vague at first. In fact, the first sign may be a small pink area. The area becomes warm to the touch as the blood clot becomes worse. If felt with your hand, the pink area will feel like a cord. Other symptoms of a blood clot in the leg include:
A blood clot is a very serious medical condition, with consequences that can be life threatening and at times, fatal. A clot in the leg can stop blood flow. When this occurs, there will be no pulse felt distal (away from, typically below) to the clot. This is why it is important to check the pedal pulse. Once blood flow to the leg is stopped by the clot, the leg will die. This can result in an amputation. A more serious scenario is a blood clot that detaches from the vein and gets stuck in a blood vessel in the lung. When this occurs the client is said to have a pulmonary embolism. The client will have shortness of breath and perhaps anxiety. This is life threatening and can quickly turn fatal. When a blood clot is suspected, always seek immediate medical attention. If shortness of breath, anxiety or sweating occur along with a suspected blood clot, call an ambulance.
Treatment is aimed at dissolving the blood clot, preventing the clot from traveling, and preventing the formation of new clots. Initially, the client should rest with the extremity elevated. A warm compress can be placed over the pink area to aid in healing. The client is started on anticoagulants (blood thinners). There are a variety of anticoagulants available, such as:
Once there is a therapeutic level (the correct dosage of medication that keeps the blood at the desired consistency) of anticoagulants, the patient can go about his/her normal routine. However, use of any anticoagulant increases the risk of hemorrhage. Patients are advised to refrain from any activities that involve even a remote possibility of injury.
If the blood clot is a result of an injury or surgery, anticoagulants must be continued for 6-9 months. For other blood clots, it is recommended to continue the use of anticoagulants for one year.
Continuous routine blood tests are required for heparin, Coumadin, and Lovenox. If the blood test shows that the blood is too thin, the patient is given vitamin K, which reverses the effects of the anticoagulant. The remaining anticoagulants do not need any blood testing. However, vitamin K will not reverse the effects of these medications and the patient can easily die from a hemorrhage. Currently there is one medication that is useful in combating the effects of some of these anticoagulants however, at this time, the medication is only being used in a few hospitals.
A blood clot is a serious condition. Left undetected and untreated, it can be life threatening.
Always treat the signs and symptoms of a blood clot as an emergency and seek immediate medical attention. Call an ambulance if the patient becomes anxious or short of breath. This is an indication that the clot has moved to the lung. This is referred to as a pulmonary embolism and can quickly become fatal.
A blood clot in the leg can begin as a small pink area somewhere on the leg. As the clot worsens, the pinkness becomes larger, more intense in color and warm to the touch. Within the area of discoloration, you may feel a cord. If a blood clot is present, the patient will have a positive Homan's sign (pain in the calf when the foot is flexed). You should always check for a pedal pulse ( a pulse over the top arch of the foot). If there is no pulse, the blood clot may stop blood flow to the leg causing serious damage and perhaps the need for amputation.
Treatment consists of anticoagulants (blood thinners), such as Coumadin, Lovenox, and Xarelto, to name a few. Anticoagulants thin the blood and help dissolve the blood clot that is present. They also prevent additional clots from forming. A blood clot that occurs after surgery or as a result of an injury or surgery is treated for 6-9 month. A blood clot that occurs without surgery or injury is treated for at least one year. In addition to anticoagulants, rest, elevation, and warm compresses are prescribed at the onset of symptoms. Once a therapeutic level of anticoagulants has been achieved, the patient can go about his/her day normally, but he/she must avoid any activities that may produce an injury.
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