Complications of Deep Vein Thrombosis (DVT)

Pulmonary Embolism
The most dangerous complication of deep vein thrombosis (DVT) is pulmonary embolism, which occurs when an embolism travels through the heart and into the lungs. There it lodges in an artery, typically where the artery forks, and blocks blood flow. The lungs are particularly vulnerable to embolisms because all the blood in the body passes through the lungs every time it circulates. Depending on the size of the embolism and where it lodges, the result can be asymptomatic (without symptoms) or a life-threatening medical emergency in which large amounts of lung tissue, deprived of blood, die. Often not one but many embolisms shower the lungs during an episode of pulmonary embolism.

Symptoms of pulmonary embolism include:

• Lightheadedness, dizziness
• Sudden shortness of breath, either when active or when at rest
• Chest pain like that of a heart attack in the chest and possibly radiating to the shoulder, arm, neck, or jaw
• Cough with bloody sputum

Pulmonary embolisms can be fatal. If signs of a pulmonary embolism develop, medical attention should be sought immediately.

Heart Attack
Thromboembolisms can cause heart attacks as well. A clot can become lodged in one of the heart's coronary arteries (the arteries that supply the heart muscle tissue with blood) so that the tissue becomes starved of oxygen and dies. The medical term for a heart attack is myocardial infarction.

Symptoms of Heart Attack

• Pressure or squeezing pain in the center of your chest that lasts for more than a few minutes
• Pain similar to that of angina but that is generally more severe, lasts longer, and doesn't respond to rest or angina medication
• Pain that extends beyond your chest to your shoulder, arm, back, or jaw (referred pain)
• Increasing episodes of chest pain
• Prolonged pain in the upper abdomen
• Shortness of breath
• Heavy pounding of heart
• Sweating
• Sense of impending doom
• Fainting
• Nausea and vomiting

Heart attacks are medical emergencies. Anyone who might be having a heart attack should get to a hospital emergency room as quickly as possible. The sooner treatment begins, the better the chances of survival.

Stroke
A blood clot can travel to the brain and become lodged in one of its arteries. The resulting, severely reduced blood flow is called ischemia. About 83% of all strokes are ischemic. Deprived of the blood that brings them oxygen and glucose (a sugar), brain cells become stressed or damaged. The amount of damage done to brain cells depends on how long they are deprived. If it's for only a brief time, they may recover. If they are deprived of oxygen for a longer period of time (and this can mean just a few minutes) they may die, and some functions may be lost.

There are two types of ischemic stroke:

• Thrombotic stroke. A thrombus forms in one of the arteries that supplies blood to the brain. This can occur in one of the arteries of the neck as well as in the brain itself.
• Embolic stroke. A thrombus forms in another part of the body, often in the heart, and travels through the arteries until it becomes stuck in the narrower arteries of the brain.

Strokes are medical emergencies that require immediate medical attention, so it's very important to know the signs and symptoms of stroke:

• Sudden numbness, weakness, or paralysis, especially on one side of the body
• Sudden confusion or change in consciousness
• Sudden vision problems in one or both eyes
• Sudden dizziness, difficulty walking, loss of coordination
• Sudden, severe headache
• Sudden difficulty speaking or understanding speech

If you think someone is in fact having a stroke:

• Call for emergency medical help immediately.
• If the person stops breathing, begin mouth-to-mouth resuscitation.
• If he or she starts to vomit, turn their head to the side to prevent choking.
• Don't let the person eat or drink anything.

Don't wait to call for help. The success of most stroke treatments depends on how soon they are administered.

Cor pulmonale
Cor pulmonale is failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle of the heart. When there is a blockage in the lung's arteries due to an embolism, blood pressure in the lungs (pulmonary resistance) increases. The heart's right ventricle, the chamber that pumps blood to the lungs, pumps harder to compensate. The overworked heart becomes enlarged, which makes it weaker. (Unlike other muscles in the body, the heart becomes weaker, not stronger, as it becomes larger.) Eventually the heart may fail to perform. Cor pulmonale is usually a chronic disease, but massive pulmonary embolism can make it acute. In the US, about 50,000 deaths occur per year from pulmonary emboli, and about half occur within the first hour due to acute right heart failure.

Initially there may be few symptoms of cor pulmonale. When the disorder is advanced or acute, symptoms may include:

• Fatigue and shortness of breath on exertion
• Dizziness
• Chest pain
• Wheezing or coughing

Symptoms of heart failure may also develop:

• Edema in the legs
• Progressively worse shortness of breath

Left untreated, cor pulmonale can lead to right-heart failure and death. Anyone experiencing acute symptoms of cor pulmonale should seek medical treatment immediately.

More on this topic

What Are Thrombosis & Embolism? (VIDEO)
Your Blood Moves
Thrombus & Embolus
Symptoms & Risk Factors
Blood Must Flow
Consequences of Clots
Tests & Diagnosis for DVT
Prevention & Treatment

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