Northwest Indiana medical malpractice lawyer discusses the perils of deep vein thrombosis and pulmonary embolism.
A 45 year-old man who just traveled to Indiana from the west coast and then drove from Evansville to Merrillville starts to develop some non-specific chest pain, cough and shortness of breath. His friends take him to the Emergency Room of a Northwest Indiana hospital – Pulmonary embolism (PE) must be in the Emergency room doctor's differential diagnosis. If the healthcare provider does not rule out PE dire consequences or death is certain.
Deep venous thrombosis is the development of a blood clot in the large, deep veins of the lower leg and thigh. Thrombi (clots) can cause tissue injury because it closes down the blood vessel like a cork or it can form a clot that moves through the body known as emboli.
Thrombi can cause local pain and swelling because blood flow is blocked. If the clot breaks off and travels through the blood, it is referred to as an embolism. An embolism can get trapped in the brain, lungs, or heart leading to injury or death.
Pulmonary Embolism is a common complication and life threatening if not treated quickly with blood thinners. A patient with PE goes to the hospital or doctor with shortness of breath, chest pain, and sometimes a cough with blood tinged sputum.
Deep Vein Thrombosis can occur with stasis (stoppage of blood flow) or in hypercoaguable (blood is thick and sticky) states. DVT is commonly seen after trauma, surgery, or burns, which contribute to decreased physical activity, damage to vessels, and release of chemicals that make the blood sticky. Reduced physical activity (which can occur with long travel) causes a decline in the milking action of lower leg muscles and slows venous return.
There are a number of risk factors associated with Deep Vein Thrombosis:
birth control pills
family history of blood clots
fractures in the pelvis or legs
People, like our 40 year old guy above, should move their legs during long flights or when they are immobile for long periods of time to help prevent DVT and PE. People with DVT can have no symptoms at all. Some people experience chronic pain and swelling in the lower legs. The classic symptoms of DVT include changes in a patient's leg such as redness, increased temperature, pain, and tenderness.
Diagnosis of Deep Vein Thrombosis
DVT is diagnosed by physical exam, which may show a leg that is red and swollen. A number of lab tests can show that a patient's blood is thick and sticky. A special ultrasound (Doppler) of the leg can show the presence of stasis (lack of blood flow). If PE is suspected a special x-ray of the chest called spiral computerized tomography is indicated.
Treatment of Deep Vein Thrombosis
Blood thinners are used to treat DVT. Blood thinners prevent the formation of new clots and the growth of old clots. Blood thinners do not dissolve existing clots. Coumadin is a medication used to treat DVT; however,patients on coumadin have to undergo regular blood tests (INR) to make sure the blood does not get too thin.
Failure to Timely Diagnose Deep Vein Thrombosis
If DVT is not timely and properly diagnosed patients suffer injury and/or death. Pulmonary Embolism is the number one killer associated with DVT. Emergency room personnel and family practice doctors have to be on the lookout for this condition. If PE is expected, the patient must be started immediately on blood thinners and a spiral CT has to be ordered to determine the nature and extent of blood clots in the lungs.
Indiana medical malpractice law is complex. If you have any questions about the failure to timely diagnose Deep Vein Thrombosis or Pulmonary Embolism, fill out the internet consultation form on the right.