Risk factors for deep vein thrombosis and pulmonary embolism

The article is professionally consulted by Dr., Doctor Nguyen Luong Tan - Head of Cardiology Department - Cardiovascular Center - Vinmec Central Park International General Hospital. The doctor is an expert in the field of thoracic and cardiovascular surgery in adults and children.

The most known causes of deep vein thrombosis are coagulation disorders, damaged vessel walls, and immobility. Causes of deep vein thrombosis are closely related to pulmonary embolism. What are the risk factors for deep vein thrombosis and pulmonary embolism?

Deep vein thrombosis is a condition in which a blood clot (thrombus) forms, grows in large veins (leg veins, arm veins) and does not move. There are 3 main groups of causes of deep vein thrombosis:
Immobility Injury to the walls of blood vessels Coagulation disorders Most causes of deep vein thrombosis belong to the group of coagulation disorders and immobility. In addition, the risk factors for venous thromboembolism are also classified into genetic factors and acquired causes.
In which, innate genetic factors are involved in the deficiency of natural clotting inhibitors such as protein C, protein S, antithrombin. Acquired risk factors include immobility (trauma, surgery, long-term car or plane travel), pregnancy, postpartum period, blood clotting disorders (lupus). , certain malignancies (cancer) and hormone replacement therapy.
Causes of pulmonary embolism are closely related to risk factors for venous thrombosis. Mainly the thrombus formed in the leg veins migrate to the pulmonary artery system causing pulmonary artery occlusion.
In the body, all the veins carry blood to the larger veins, then to the right heart and pulmonary artery. Normally, the thrombus travels from the vein to the right heart, then enters the main pulmonary artery and smaller branches, blocking the lumen there, causing a pulmonary embolism. Or the thrombus may continue to travel into different areas of one or both lungs.
MORE: How is deep vein thrombosis treated?

Recognizing the risk factors for deep vein thrombosis can help detect and prevent pulmonary embolism early. Accordingly, the risk factors for deep vein thrombosis and pulmonary embolism include: coagulopathy; abnormalities in blood vessels (varicose veins); cancer, heart diseases; immobility; use of oral contraceptives and hormones; several other factors (age, obesity, being pregnant or after giving birth).

Factor V Leiden is a common inherited blood clotting disorder that increases the risk of deep vein thrombosis. People with mutations in the gene that regulates factor V Leiden, glutamine replaces arginine - amino acid at position 506. A family history of blood clots helps detect inherited blood clotting disorders.

Varicose veins are one of the vascular abnormalities that increase the risk of venous thrombosis and pulmonary embolism, although controversial. In elderly patients with varicose veins, this risk is higher than in younger patients.

In cancer patients, deep vein thrombosis is a common complication. A history of cancer or advanced cancer is one of the risk factors for venous thrombosis. In particular, this rate is higher in patients with gastrointestinal cancer, lung cancer, breast cancer and brain cancer.
Causes of increased risk of deep vein thrombosis in cancer patients may be due to:
Tumor encroaching on the vessel wall or occlusion of the vein. Advanced cancer stages increase some of the clotting inhibitors such as fibrinogen, factor VIII. In addition, cancer treatments such as surgery, radiation therapy, chemotherapy, in which a central venous line is placed, increase the risk of venous thrombosis. In particular, chemotherapy is a method that increases the risk of venous thrombosis due to decreased antithrombin activity in the blood. When chemotherapy is discontinued or the patient receives prophylaxis, the risk of venous thrombosis is reduced.

Heart failure: Chronic heart failure is an independent risk factor for venous thromboembolism, especially in patients with NYHA class III and IV heart failure. Myocardial infarction: In addition to heart failure, myocardial infarction is also associated with deep vein thrombosis, this risk is higher when patients with other factors are older, often in a state of immobility, congestive heart failure causes circulatory stagnation. Stroke: Patients recovering from an acute stroke often experience a serious complication of venous thrombosis. However, the risk of venous thromboembolism and pulmonary embolism is difficult to recognize because of the absence of clinical symptoms.

Patients undergoing treatment, trauma, surgery often in a state of bed immobility is one of the factors that increase the risk of venous thrombosis. This is an independent factor and in combination with other risk factors (age) also increases the incidence of venous thrombosis. Traveling by plane or driving continuously for many hours (> 8 hours) has also been studied and shown to increase the risk of venous thrombosis.

Birth control pills containing the hormones estrogen and progestogen have been studied and proven to increase the risk of venous thrombosis. Postmenopausal women on hormone replacement therapy and who have never had a hysterectomy have also been studied and found to be at increased risk for venous thrombosis.

Age: Age is an independent factor and increases the risk of VTE with age. Besides, other co-morbidities in elderly patients, often sedentary, decreased muscle tone, degenerative circulatory system also increase this risk. Pregnancy and postpartum: The risk of venous thromboembolism is increased in pregnant women and is especially higher at 6 weeks postpartum. Obesity: Although controversial, obesity is also one of the risk factors for venous thrombosis. Risk factors for deep vein thrombosis and pulmonary embolism include coagulopathy (inherited), varicose veins; cancer, heart diseases; immobility; use of oral contraceptives and hormones; age, obesity, pregnancy or after giving birth. The more likely you are to form a blood clot, the more risk factors you have. Deep vein thrombosis can be detected with color Doppler ultrasound and early treatment can help relieve symptoms and prevent pulmonary embolism. Therefore, patients should perform periodic health check-ups to early detect the medical condition, intervene when necessary to ensure health later.
With many years of experience in the examination and treatment of cardiovascular diseases, now Vinmec International General Hospital has become one of the major Cardiology centers, possessing a team of qualified doctors and nurses. , well-trained and has a system of modern facilities and medical equipment. As a result, the Cardiovascular Center at Vinmec International General Hospital is capable of examining, treating and monitoring after treatment of diseases such as deep vein thrombosis, pulmonary embolism,...
The entire procedure The process of examination, monitoring, recovery and treatment of the disease is always integrated with many specialties to provide the opportunity for a quick recovery, avoiding the recurrence of the disease.
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