Scott Webb (Host): Blood clots are preventable and treatable, and my guest today is here to explain and share the signs, symptoms, and treatment options at Eisenhower Health. I'm joined today by Dr. Mehul Patel. He's a pulmonologist and critical care physician with Eisenhower Health.

This is Living Well with Eisenhower Health. I'm Scott Webb. Doctor, it's so nice to have you here today. We're going to talk about blood clots, and I've got a lot of questions for you. So, let's start there, what is a blood clot and how do deep vein thrombosis and pulmonary embolism kind of fit into that definition?

Dr. Mehul Patel: Venous thromboembolism or VTE is a medical term for a blood clot that forms in a vein. It includes two related conditions. A deep vein thrombosis or a DVT, which happens when a clot forms in a deep vein, usually in the legs. If the clot breaks off and travels to the lungs, it's called a pulmonary embolism or a PE. Together, they form what we call a venous thromboembolism. Both can be serious, but thankfully they're preventable and treatable when caught early.

And just to give you some facts, every year blood clots claims the lives of more than a hundred thousand people in the United States. That's about one person every six minutes or 274 people each day. Yet, what's truly striking is that blood clots are often preventable and treatable when they're recognized early. Despite those staggering numbers, fewer than 6% of Americans know what a blood clot is and how to prevent them, even though they affect as many as 900,000 people each year.

Host: Right. Yeah. Well, you say 6%. Hopefully, we'll be able to raise that by having you on today and talking through some of this. And you mentioned there about, you know, early diagnosis being key. So, let's talk about the causes or risk factors, you know, that can even increase someone's chance of developing a blood clot in the veins so that maybe we catch these a little earlier.

Dr. Mehul Patel: Several things can increase your risk. So, prolonged immobility, like during a long travel; hospitalization or bed rest, recent surgery or trauma, especially orthopedic and abdominal surgeries, having underlying cancer, pregnancy and postpartum period; being on certain medications such as hormonal therapy or birth control pills; obesity, smoking. And there are also genetic clotting disorders that may predispose someone, and as well as older age and chronic comorbidities, such as heart failure or inflammatory diseases. Knowing your own personal risks helps you and your doctors take preventative steps.

Host: Right. Yeah, and you mentioned older age there, and I wanted to stay with that because I think a lot of us just associate blood clots, you know, with older adults. So, is that a condition that really only affects older people or can it really happen at any age?

Dr. Mehul Patel: While the risk does increase with age, blood clots can happen at any age. Younger people can develop clots too, often triggered by factors like long travel, injuries, hormone use, or genetic predisposition. So, even healthy adults should know the warning signs and stay alert in situations that raise risk.

Host: Yeah. Warning signs, that's key. And so, let's talk about that, Doctor, some of the typical symptoms, if you will, of deep vein thrombosis in the leg and when we should seek attention.

Dr. Mehul Patel: So, common warning signs of a DVT include swelling in one leg, rarely in both; pain or tenderness, often in the calf; warmth, redness, or discoloration of the skin. If these appear, especially if symptoms affect just one leg, seek medical care immediately. An untreated DVT can break loose and travel to the lungs causing a pulmonary embolism

Host: Yeah, that you must have read my mind, Doctor, because that's what I wanted to ask you about next. Like, you know, when a clot does travel to the lungs and causes a pulmonary embolism, what symptoms might we experience and how serious is that condition?

Dr. Mehul Patel: Pulmonary embolism is a medical emergency. Symptoms may include sudden onsets of shortness of breath, sharp or stabbing chest pain that worsens with deep breaths, rapid heartbeat, coughing sometimes with blood, feeling lightheaded or faint, and some people may even pass out or have syncope. If you experience these symptoms, call emergency service immediately. PE can be fatal if untreated. But quick action and treatment dramatically improve survival.

Host: So then, doctor, how is a blood clot diagnosed really? Like, what kinds of tests might a patient go through in order to get that early diagnosis?

Dr. Mehul Patel: So, doctors use a combination of physical examination, blood test, and imaging test to diagnose blood clots. These may include ultrasound of the leg to look for DVT, CT pulmonary angiogram to look for pulmonary embolisms. We can also use combination of blood tests and heart echocardiograms to further risk stratify severity of pulmonary embolism. The specific test depends on your symptoms and risk factors.

Host: So, it's not a one-size-fits-all. Then doctor, let's talk about the treatments that are available. I'm assuming there, you know, you have a number of tools in your toolbox, so to speak. But if a blood clot is found, how do these treatments help prevent further complications? And how does Eisenhower Health help, you know, expedite treatment of life-threatening pulmonary embolism?

Dr. Mehul Patel: So, treatment focuses on stopping the clot from growing and preventing new clots. We generally use medications called anticoagulation, medications, commonly known as blood thinners, such as heparin, warfarin, or newer agents such as oral agents called apixaban or rivaroxaban.

In some instances, we use what's called thrombolytic therapy or clot busters. These are used in life-threatening cases of pulmonary embolism. Here at Eisenhower, we've also incorporated what we call catheter-directed, thromboembolectomy or catheter-directed suction devices to help us treat some of these high-risk pulmonary embolisms. And in some cases, patients may also benefit from having a filter, what we call an inferior vena cava filter to stop clots from traveling to the lungs. Generally, treatment duration with anticoagulation for most patients last three to six months. However, for some patients, this may be longer depending on their risk factors.

Host: Yeah. And you mentioned earlier the causes, risk factors. I want to sort of find out for you if I can, like, can we prevent blood clots? Like, is that a thing? You know, especially if we're at higher risk, let's say, after a surgery or during long periods of travel.

Dr. Mehul Patel: Yes, prevention is key. Here are some helpful tips to take. Move regularly. If you're sitting for hours, stand up and walk every one to two hours. Flex your legs and ankles to encourage circulation during travel. Staying hydrated helps. Maintain a healthy weight and avoid smoking. After surgery or hospitalization, take the prescribed blood thinners and use compression devices if recommended. In hospital, there are prevention protocols and standards that are usually followed, but patients should ask their care team about their personal clot risk and to see if there's any other recommendations to mitigate these.

Host: Yeah. And you mentioned earlier, Doctor, you said that it's about 6% of us that really know what a blood clot is. So, how do we do that besides a podcast like this, of course? How do we increase awareness to the general public of blood clots and why is it so important, do you think, to have a dedicated month where we talk about blood clots?

Dr. Mehul Patel: Blood clots remains underrecognized despite being one of the leading causes of preventable hospital deaths. A dedicated awareness month like March being Blood Clot Awareness Month helps educate people on warning signs and prevention, encourages those at risk to speak up to their healthcare providers, highlights ongoing research and public health efforts.

Host: Yeah. And, Doctor, this has been good stuff today since it's obvious that most of us really don't know. We think we do, but we really don't know what blood clots are. And we need to talk more about them, and we are. Because, as you mentioned, March is Blood Clot Awareness Month. So, what would be your key message takeaways for listeners that you really want them to remember after this podcast about deep vein thrombosis, pulmonary embolism, all that stuff?

Dr. Mehul Patel: So, the biggest takeaway is listen to your body and don't ignore the warning signs. Blood clots are common, but they're also largely preventable and treatable when caught early. Stay active. Know your risk. Ask for preventative care when hospitalized and spread the word. Awareness saves lives.

And I just want to highlight that at Eisenhower Health, we take a highly proactive and coordinated approach to diagnosing and treating blood clots. Our multidisciplinary team includes emergency medicine physicians, pulmonary and critical care specialists and interventional radiologists. Together, we operate through what's called a pulmonary embolism response team, which allows us to rapidly assess each case and tailor treatment strategies in real time.

We also incorporate advanced imaging technologies and artificial intelligent tools that assist in the early detection of pulmonary embolism. These technologies help flag concerning findings quickly, allowing our teams to expedite treatment. Whether this involves anticoagulation, catheter-directed therapies, or surgical interventions, our goal is simple but urgent. Identify blood clots early, intervene decisively, and deliver the highest standard of care to protect our patients lives.

This March, we encourage everyone to learn the signs, understand the risk factors, and seek immediate care if symptoms arise. Awareness and timely action makes all the difference.

Host: Yeah, awareness saves lives, and I love those two words: preventable, treatable, all good stuff. Thank you so much. And for more information, go to eisenhowerhealth.org/services/pulmonology. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. I'm Scott Webb. And this has been Living Well with Eisenhower Health. Thanks for listening.