Mary Cushman, M.D. - What I Wish All My Patients Knew About VTE
Mary Cushman, an American Heart Association spokesperson, is a hematologist at the University of Vermont Medical Center, where she is medical director of the Thrombosis and Hemostasis Program. Dr. Cushman is also a Professor of Medicine and Pathology and at the Larner College of Medicine at UVM in Burlington, VT. She is the Editor-in-Chief of Research and Practice in Thrombosis and Haemostasis, an open-access scientific journal. She writes in honor of World Thrombosis Day on October 13.
Every year, October 13 is World Thrombosis Day. This is an occasion to raise awareness of blood clots. There are a three things that I wish more people knew about VTE.
1. Awareness is too low. Blood clots can occur in the legs or in the lungs, also called deep vein thrombosis (DVT) or pulmonary embolism (PE). Taken together, these conditions are the 3rd leading vascular disease after heart attack and stroke, affecting 1-2 in every 1000 people each year, and many more as people age (nearly 1% every year for people in their 90s) or develop risk factors (up to 6 in every 1000 each year with obesity). If more people knew about VTE and knew the symptoms, there would be a great opportunity for prevention
2. Hospitalization is a major risk factor. About 2 in 5 of all VTEs occur during or after hospital stays. The risk is especially high if you have surgery or have a spend time in the intensive care unit. It is very important for hospitalized patients to ask their care team what is being done to prevent VTE. Your care team should be individualizing a prevention plan based on your risk profile. This is effective at lowering VTE risk.
3. Cancer patients are at high risk and most don’t even know this. VTE is the leading cause of death in cancer patients, after the cancer itself. About 1 in 5 of all VTEs occur in patients with cancer and there is a high death rate when this happens. It’s amazing to me that about 1 in 10 cancer patients starting chemotherapy develop a VTE within 1 year, and most don’t know this. It is possible with risk assessment to determine if you have a higher or lower VTE risk. If your risk is high, then certain measures can be taken; in some cases low dose blood thinning medication is used.
So, take October 13 to teach yourself about VTE. There is great information at Heart.org/VTE.
What do you wish you had known about PAD? Join the Support Network to comment below and share your experience.
References
- Benjamin EJ, Virani SS, Callaway CW et al. Heart disease and stroke statistics - 2018 update: a report from the American Heart Association. Circulation 2018:137:e67-e492.
- Wendelboe AM, McCumber M, Hylek EM et al. Global public awareness of venous thromboembolism. J Thromb Haemost 2015;13:1365-71.
- Wang TF, Li A, Garcia D. Managing thrombosis in cancer patients. Res Pract Thromb Haemost 2018;2:429-38.
