• Traveler's Thrombosis: When Sitting Still Can Be Dangerous

    What Is DVT?

     Deep vein thrombosis (DVT, also known as venous thromboembolism) occurs when a blood clot develops in the deep veins of the legs and groin (the lower-abdomen/upper thigh areas). These deep veins are not visible at the skin's surface, and are not related to varicose veins. A clot that breaks loose and travels through the deep veins to the heart (heart attack) and lungs (pulmonary embolism) can cause severe blockage of blood flow or death. Clots may also travel to the brain causing a stroke in people born with a hole in their heart.

    Symptoms, Diagnosis, and Treatment

    People who develop DVT don't always have symptoms. However, those who do usually experience the following symptoms in one leg or the other (rarely both):
    Symptoms of DVT may include:
    • Pain
    • Swelling of a limb
    • Tenderness along the vein
    • Warmth
    • Redness, paleness, or blueness of the skin of the affected limb
    Sudden, severe shortness of breath, with or without chest pain, may signal that a clot has traveled to the lungs.
    DVT can be diagnosed by ultrasound imaging tests, which highlight blood flow in the veins and show clot formation. If a clot is found, blood-thinning medication to stabilize the clot and allow it to dissolve will be prescribed immediately. Hospitalization may be required for treatment and observation. Oral medications may be necessary to ensure continued normal blood flow through the vein.

    Risk Factors

    Risk factors for DVT include:
    • Personal or family history of deep vein thrombosis
    • Hospitalization
    • Not moving your body for long periods of time
    • Surgery, especially involving bones or joints
    • Medical conditions, such as:
    • Obesity
    • Taking birth control pills or estrogen therapy
    • Pregnancy
    • Smoking
    • Genetic factors whether inherited or by natural changes in life can change your body protein levels

    Preventing DVT While Traveling

    If you are planning any kind of travel that requires sitting for long stretches of time, be sure to do the following:
    • Get up and walk around as much as possible—At least once an hour, if possible. Stand up and stretch your arms and legs in your seat if there is no room to walk.
    • Do in-seat calf exercises and heel/toe lifts frequently to keep the blood circulating.
    • Arrange optimal seating—Try to sit in an area that affords you some space, such as an aisle, exit row, or bulkhead seat.
    • Stay hydrated, drink plenty of fluids, but avoid drinks that contain alcohol.
    • Avoid smoking—This is especially important if you are taking oral contraceptives.
    • Wear loose clothing and avoid tight clothing that restricts blood flow, such as pants with tight waistbands.
    • If you are at high risk for developing DVT, your doctor may ask you to wear below the knee compression stockings.
    One cautionary note: DVT may surface after travel has been completed. If you experience any of the symptoms listed above, contact your doctor immediately.

    RESOURCES

    National Institutes of Health http://www.nih.gov

    Travelers' HealthCenters for Disease Control and Prevention http://wwwnc.cdc.gov

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com

    References

    Deep vein thrombosis (DVT). DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated Ocotober 2, 2014. Accessed October 13, 2014.

    Deep vein thrombosis and pulmonary embolism. Centers for Disease Control and Prevention Travelers Health website. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-2-the-pre-travel-consultation/deep-vein-thrombosis-and-pulmonary-embolism. Updated August 1, 2013. Updated October 13, 2014.

    Explore deep vein thrombosis website. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/dvt. Updated October 28, 2011. Accessed October 13, 2014.

    Focus on: Emergency ultrasound for deep vein thrombosis. American College of Emergency Physicians website. Available at: http://www.acep.org/content.aspx?id=44490. Accessed October 13, 2014.

    Gavish I, Brenner B. Air travel and the risk of thromboembolism. Intern Emerg Med. 2011;6(2):113-116.

    Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e195S-226S.

    Philbrick JT, Shumate R, et al. Air travel and venous thromboembolism: A systematic review. J Gen Intern Med. 2007;22(1):107-114.

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