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Blood-Clot-Drug-Lawsuit-SourceBlood Clot: Causes, Symptoms, Prevention, Medications and Treatments

Commonly asked questions about blood clots:

What is a Blood Clot?

A blood clot is a mass of blood that changes from a liquid state to a more solid state. In certain situations, such as when you injure or cut yourself, blood clotting is beneficial and can prevent you from losing too much blood. However, when a blood clot forms inside of your veins it won’t necessarily dissolve on its own. This can become very dangerous and even potentially life-threatening.

How Does a Blood Clot Form?

Blood clotting, also known as coagulation, prevents excessive bleeding when a blood vessel becomes injured. A type of blood cell known as platelets along with proteins in your plasma work in combination to stop the bleeding and clot over the injury. Normally after the injury has healed your body will naturally dissolve the blood clot. However, sometimes clots can form on the inside of blood vessels without any injury or do not dissolve naturally. These life-threatening clots that form inside of the body are known as deep vein thrombosis (DVT). If an abnormal clot occurs in a vein it can restrict the return of blood to the heart and can result in pain and swelling as blood gathers behind the clot, leading to a potentially larger clot.

What Risk Factors Are Associated With Blood Clots?

There are many different factors that can increase your risk of developing a blood clot or DVT. The Mayo Clinic reports that the more of these risk factors you possess the greater the chance of you developing a form of blood clot. These risk factors include:

  • Blood Clotting Disorder: Some people are born with a blood clotting disorder that can make them more susceptible to developing a blood clot. However, having one of these conditions may not make a difference unless combined with another risk factor.
  • Prolonged Bed Rest or Immobility: When your legs are not moving your muscles are unable to help your blood circulate, making it more likely for you to develop a blood clot in your legs.
  • Injury or Surgery: Injury to veins or surgery can increase your chance of developing a blood clot.
  • Pregnancy: During pregnancy there is increased pressure on your veins in your pelvis and legs. Women who have a previously existing clotting disorder are especially at risk. The increased risk of blood clots can continue up to six weeks after the baby is born.
  • Birth Control Pills or Hormone Therapy: Both of these medications can increase your blood’s ability to clot.
  • Being Overweight or Obese: Being overweight can increase the pressure on the veins in your pelvis and legs, leading to an increased chance of developing a blood clot.
  • Smoking: Affects blood clotting ability as well as circulation, which can increase your chance of developing a DVT.
  • Cancer: Some forms of cancer such as (pancreatic, lung, multiple myeloma and hematologic malignancies) can increase the amount of substances in your blood that cause your blood to clot. Some forms of cancer treatment can also increase the risk of developing a blood clot.
  • Heart Failure: People that have suffered from heart failure have a greater chance of developing DVT. This is because people who suffer from heart failure have limited heart and lung function.
  • Inflammatory Bowel Disease: Bowel diseases such as Crohn’s disease and ulcerative colitis can increase the chance of developing a DVT.
  • Age: If you are over the age of 60, you have an increased chance of developing DVT.

What Symptoms/Signs Are Associated With Blood Clots?

It is possible to have a blood clot without any form of obvious symptoms. However, if you do have noticeable signs and symptoms the things to look for will depend of the size and location of the clot. Health Line reported a list of the symptoms/signs to look for if you have a blood clot in the leg, heart, abdomen, brain or lungs.

  • Leg: The most common place to develop a blood clot. If you have a blood clot in your leg there can be various symptoms, such as:
    • Swelling
    • Pain
    • Tenderness
    • A warm sensation
    • Pain in your calf when you stretch your toes upward
    • A pale or blueish color distortion
  • Heart: It is much less common to develop a blood clot here. However, it is still a possibility.
    • Pain or a heavy feeling in your chest
    • Lightheadedness
    • Shortness of breath
  • Abdomen: The following are potential symptoms of a blood clot in the abdomen. However, they may also be signs of a stomach virus or food poisoning.
    • Severe abdominal pain
    • Vomiting
    • Severe diarrhea
  • Brain: The symptoms for a blood clot in the brain can all come on suddenly.
    • Sudden and severe headaches
    • Sudden difficulty seeing
    • Sudden difficulty speaking
  • Lungs: A blood clot that travels to the lugs is referred to as a pulmonary embolism (PE). Some of the possible symptoms associated with a PE are:
    • Sudden shortness of breath
    • Chest pain
    • Rapid heart rate
    • Breathing problems
    • Coughing up blood

What Medications Are Used To Treat Blood Clots?

The following is a list of potential medications that can be taken to help prevent blood clots from forming and growing. This list reported by The National Blood Clot Alliance includes:

  • Unfractionated Heparin (UF): Is a fast acting blood thinner that is taken by an IV or through an injection under the skin.
  • Low Molecular Weight Heparin (LMHW): Is very similar to heaprin however you are able to administer it yourself at home through an injection or shot under the skin. The effects of LMHW are more predictable than regular UF heparin, so you do not require monitoring.
  • Warfarin (Coumadin): A pill that is taken for long term blood thinning. Warfarin is monitored through regular blood testing.

New Anticoagulate/Anti-Clotting Medications

Recently the FDA has approved several new blood-thinning medications. These medications are Rivaroxaban (Xarelto), Apxiban (Eliquis) and Dabigatran (Paradaxa). However these newer medications come with multiple pros and cons with their use.
Pros

  • Do not require frequent lab monitoring
  • Have fewer drug/herbal interactions
  • Fewer fatal bleeding events
  • Take effect quickly and do not require an overlap of heparin

Cons

  • Require dietary restrictions
  • Are very expensive
  • Do not have antidotes, making it very difficult to reverse anti-clotting factor
  • Effects can wear off quickly
  • Effects may be eliminated through kidneys or liver

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Resources

Goldhaber S, Morrison R, Pulmonary Embolism and Deep Vein Thrombosis, 2002, Circulation, Vol 106 (2) 1436-1438

Rathbun S, The Surgeon General’s Call to Action To Prevent Deep Vein Thrombosis and Pulmonary Embolism, 2009, Circulation, Vol 119 (15), E480-E482