Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured.
However, if a blood clot forms inside one of your veins unexpectedly and does not dissolve on its own, this can be a very dangerous and even life-threatening situation. Failure to diagnose and treat these either acutely or prophylactically can lead to devastating circumstances.
Types of blood clots
The circulatory system is made up of vessels called veins and arteries, which transport blood throughout the body. Blood clots can form both in veins and arteries.
When a blood clot occurs in an artery, it is called an arterial clot. This type of clot causes symptoms immediately and requires emergency treatment. The symptoms of an arterial clot include severe pain, paralysis of parts of the body, or both. It can lead to a heart attack or stroke.
A blood clot that occurs in a vein is called a venous clot. These types of clots may build up more slowly over time, but they can still be life-threatening. The most serious type of venous clot is called deep vein thrombosis.
What are the risk factors?
Certain risk factors increase your chances of having a blood clot. Failure to take these factors into account when presented with symptoms of a clot to help diagnose and treat quickly may well be a breach of duty of care. These factors should also be considered when preparing for surgeries, etc.
Common factors that can put you at a moderate risk for a blood clot include:
- Age, especially if you’re over 65 years old
- Lengthy travel, such as any trips that caused you to sit for more than four hours at a time
- Bed rest or being sedentary for long periods of time
- Lengthy stays at the hospital or major surgeries
- A family history of blood clots
- Certain birth control pills
- Autoimmune disorders
- Diseases related to chronic inflammation
- Certain infections (HIV/AIDS, hepatitis C, or Lyme disease)
General Symptoms of Blood Clots
Blood clots can form in different parts of the body causing different symptoms depending on its type (arterial or venous) and its location in your body. We have addressed some of these below.
However, there are some more generalised symptoms that can be caused by blood clots and should be addressed if unaware of a particular source.
- Sudden shortness of breath;
- Chest pressure;
- Difficulty breathing, seeing, or speaking.
Deep Vein Thrombosis (DVT)
Deep vein thrombosis (DVT) is the name for when a clot forms in one of the major veins deep inside your body. It is most common for this to happen in one of your legs, but it can also happen in your arms, pelvis, lungs, or even your brain.
The symptoms would usually depend on the place of the blood clot, following which it is worth considering information below regarding specific symptoms.
Blood clot in the leg or arm
One of the most common places for a blood clot to occur is in the lower leg. It is interesting to note that it is less common to have blood clots in both of the legs or arms at the same time.
Blood clot in a leg or arm can have various symptoms, including:
- A warm sensation
- Reddish discoloration
Blood clot in the heart, or heart attack
The heart is a less common location for a blood clot, but it can still happen. This would usually result in a heart attack.
The most common symptoms would be similar to those for a person experiencing a heart attack and would include the following:
- Chest pain;
- Shortness of breath
Blood clot in the abdomen
A blood clot can also form in your abdomen. The most common symptoms would be as follows:
- Nausea or vomiting
- Severe pain in your abdomen
- Bloody stools
- A sensation that feels like you are bloated
Blood clot in the brain
A blood clot can also form in your brain, which can lead to you having a stroke. If you are having a stroke, this requires an immediate medical attention.
The symptoms of blood clot in the brain might be very similar to stroke or heart attack and would be as follows:
- Weakness in the face, arms or legs
- Speech difficulties
- Vision difficulties
Blood clot in the lungs, or pulmonary embolism
A blood clot that travels to your lungs is called a pulmonary embolism (PE).
Symptoms that could be a sign of a PE are:
- Sudden shortness of breath that is not caused by exercise
- Chest pain
- Palpitations, or rapid heart rate
- Breathing problems
- Coughing up blood
Making the Diagnosis
Tests to check for presence of blood clots may include:
- Computed tomography (CT or CAT scan)
- Magnetic resonance imaging (MRI)
- Ultrasound studies (US)
- Angiograms or venograms
- Electrocardiograms (ECGs)
- Certain specialised blood tests
It may not be reasonable to expect all these tests to do be done and which are considered will vary depending on severity of symptoms and presentation.
Treatment of a Blood Clot
There have been many research advances that have improved the prevention and treatment of blood clots.
Some current treatments include:
- Anticoagulants: medicine that prevents clots from forming
- Thrombolytics: medicine that dissolves blood clots
- Catheter-directed thrombolysis: a procedure in which a long tube, called a catheter, is surgically inserted and directed toward the blood clot where it delivers clot-dissolving medication
- Thrombectomy: surgical removal of a clot
It is worth noting that it is still possible to develop a blood clot even if you are already taking some form of anticoagulation, after which the treatment might be to, for example, change the type of blood thinner and readjust the dose that you are taking.
Which treatment you are given depends on the situation and your previous medical history. For example, it is not reasonable to give a pregnant lady warfarin, but there are other safe anticoagulants that can be provided in the short term.
Negligent Treatment of a Blood Clot
Blood clots can be life-threatening, and if left untreated can cause further complications, some irreversible. Therefore, if you are experiencing any of the above symptoms, it is worth considering contacting your doctor or attending an A&E department.
The doctor should take a history of your symptoms and your past history. It is very important to take into account your pre-existing conditions and any previous history of blood clots. A failure to do so can result in a breach of duty.
If a blood clot is suspected appropriate tests should take place. If diagnosis is unclear, a doctor should consider further testing to rule out a potential diagnosis of blood clots. A failure to do so can result in a breach of duty of care.
On certain occasions a follow up, for example, by a haematology team should also be arranged. This is particularly if you have a history of blood clots or if you are already taking anticoagulation medication. A failure to do that can also result in a breach of duty.
It may be that treatment was given, but this was not appropriate given your particular situation. Again, if these factors are not taken into account when deciding upon treatment, this could lead to an injury over and above that which you would have had in any event, and is an actionable breach of duty.