The Ins and Outs of Blood Clots Associated with Athletes

and What to Watch for
That Could Save Lives

Health care is at its prime in today’s society, but even with amazing advances in technology and medicine, a good number of the population is walking around leading everyday lives with underlying conditions. Take for instance, the pregnant woman who delivers a full-term baby that weighs less than five pounds. After lab tests, doctors discover she has a genetic blood clotting disorder referred to as Factor V Leiden, which, most likely restricted blood flow to the baby – a condition the new mom never knew she had before pregnancy and may have never known if not for deciding to have a child.

This concept also rings true for athletes as well. When you are young, eating a healthy diet, and are in excellent physical condition, no one thinks they are at risk for life threatening problems and certainly not for blood clots. After all, none of the common risk factors including obesity, heart disease and a sedentary life style are in the picture so why worry? Unfortunately, however, even the fittest athletes are at risk according to researchers who now realize that those who are in supreme shape are quite possibly more apt to develop potentially serious complications from blood clots.

Dr. Charles Dietzek: Board-Certified Vascular Surgeon

That’s where Dr. Charles Dietzek comes in. A board-certified vascular surgeon, Dietzek founded the Vein & Vascular Institute in 2005, with offices in Voorhees, Sewell and Vineland, where he and his staff practice a full spectrum of comprehensive venous and cosmetic procedures. He has also taught more than one thousand physicians in Total Vein Care, a national physician-training course in the art of vein treatment.

Although Dr. Dietzek now does the majority of his work related to varicose veins, he continues to treat his fair share of patients with blood clots, some who are athletes who suffer from athletic-related venous situations. According to Dr. Dietzek, anytime someone gets traumatized they are set up for a clot especially if they are injured and immobile for an extended period of time. Even for those athletes who are in their prime, a leg cast could be the cause of a Deep Vein Thrombosis (DVT) or blood clot in a deep vein of the leg.

What is Deep Vein Thrombosis

DVT is a serious condition because blood clots in the deep vein scan break loose and travel through the bloodstream into the lungs. The blood clot can then occlude blood vessels, blocking blood flow. This is called a pulmonary embolism, and in some cases where the clot is large, it can result in sudden death. According to Dr. Dietzek, there is not too much that can be done to prevent a sports-related injury other than taking typical precautions such as wearing protective gear; however there are signs and symptoms to look for that require medical attention. These are swelling, pain, redness and firmness in an injured extremity.

The scary part, according to Dietzek, is that you don’t have to be disabled or unhealthy to suffer from a blood clot. “You can be perfectly healthy and young and get side-lined. Everyone is at risk especially in the event that a trauma is sustained.” So what is the silver lining? Fortunately, clots can be investigated with a simple, painless ultrasound and typically respond well to treatment with blood thinners called anti-coagulants. Dr. Dietzek recalls the story of a female athlete who was casted after suffering from a broken leg. When the cast was removed, her leg was swollen, painful and there was indeed a clot. Since it was discovered, investigated and treated in a timely manner, the end result was very successful and positive.

Another, more famous example is that of tennis great Serena Williams who in 2011 was gravely ill from a DVT. After experiencing difficulty breathing and heading to the hospital, it was discovered that she had several blood clots in both lungs. After several months off from the court, she regained strength and returned to the game. In an interesting twist, not all blood clots that break off cause significant symptoms. If you have shortness of breath at rest or chest pain occurs, these are alerting factors that a clot may have traveled to the chest blood vessels requiring urgent care.

Not All Clots are DVT

On another note, not all clots are DVT’s, according to Dr. Dietzek, who confirmed that superficial clots exist in superficial veins which are typically palpable at the skin surface. “There is a big difference in treatment between a superficial clot and a DVT. They should still be evaluated to determine that the superficial clot doesn’t extend into the deep vein system thereby confirming it is not the sign of a bigger problem.”

In fact, another surprising tidbit that most people are unaware of is that some varicose veins can be dangerous if left untreated. They can result in blood clots called superficial vein thrombosis (SVT). Varicose veins can also cause skin discoloration and damage and in severe cases skin ulcers. If varicose veins become hard, look infected or inflamed, they should be evaluated by a vein specialist. Surprisingly, according to Dr. Dietzek, no one is exempt from varicose veins. “I have seen varicose veins in teenagers, which most people don’t expect,” he said. “Everyone needs to be careful when playing sports if they receive an injury on a varicose vein because it could start a cascade that could lead to a SVT and possibly extend to become a DVT.”

For as much as clots can occur in the lower extremities (particularly the legs) they can also happen in the upper extremities. Athletes, in particular, can develop Effort Subclavian Vein Thrombosis or clots in the vessels underneath the collar bone when the muscles in the upper arms and chest are exerted which squeeze the veins. “If a person is doing a lot of upper body exercise with weights such as a body builder or athlete who lifts often, and they develop arm swelling or pain they should be evaluated for a clot.” Pitchers are also prone to develop this due to the repetitive arm motion causing injury to the blood vessels around the shoulder. The take home message is that no one is exempt,” says Dietzek. “I have even had a thirteen year old wrestler with this problem. ”

Case Study: Body Builders

One classic case of Effort Subclavian Vein Thrombosis is a body builder who suddenly develops shoulder swelling with bulging veins on one side of the shoulder and chest. This should be an alert that a clot may exist and needs treatment. “Typically, the clot is dissolved with special clot dissolving intravenous medicines. There are times when surgery was indeed a clot. Since it was discovered, investigated and treated in a timely manner, the end result was very successful and positive. Another, more famous example is that of tennis great Serena Williams who in 2011 was gravely ill from a DVT. After experiencing difficulty breathing and heading to the hospital, it was discovered that she had several blood clots in both lungs. After several months off from the court, she regained strength and returned to the game. In an interesting twist, not all blood clots that break off cause significant symptoms. If you have shortness of breath at rest or chest pain occurs, these are alerting factors that a clot may have traveled to the chest blood vessels requiring urgent care.

On another note, not all clots are DVT’s, according to Dr. Dietzek, who confirmed that superficial clots exist in superficial veins which are typically palpable at the skin surface. “There is a big difference in treatment between a superficial clot and a DVT. They should still be evaluated to determine that the superficial clot doesn’t extend into the deep vein system thereby confirming it is not the sign of a bigger problem.” In fact, another surprising tidbit that most people are unaware of is that some varicose veins can be dangerous if left untreated. They can result in blood clots called superficial vein thrombosis (SVT). Varicose veins can also cause skin discoloration and damage and in severe cases skin ulcers. If varicose veins become hard, look infected or inflamed, they should be evaluated by a vein specialist. Surprisingly, according to Dr. Dietzek, no one is exempt from varicose veins. “I have seen varicose veins in teenagers, which most people don’t expect,” he said. “Everyone needs to be careful when playing sports if they receive an injury on a varicose vein because it could start a cascade that could lead to a SVT and possibly extend to become a DVT.”

For as much as clots can occur in the lower extremities (particularly the legs) they can also happen in the upper extremities. Athletes, in particular, can develop Effort Subclavian Vein Thrombosis or clots in the vessels underneath the collar bone when the muscles in the upper arms and chest are exerted which squeeze the veins. “If a person is doing a lot of upper body exercise with weights such as a body builder or athlete who lifts often, and they develop arm swelling or pain they should be evaluated for a clot.” Pitchers are also prone to develop this due to the repetitive arm motion causing injury to the blood vessels around the shoulder. The take home message is that no one is exempt,” says Dietzek. “I have even had a thirteen year old wrestler with this problem.” One classic case of Effort Subclavian Vein Thrombosis is a body builder who suddenly develops shoulder swelling with bulging veins on one side of the shoulder and chest. This should be an alert that a clot may exist and needs treatment. “Typically, the clot is dissolved with special clot dissolving intravenous medicines. There are times when surgery

 


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