Venous thromboembolism: The deadly condition that affects more men than women



When he was 58 years old, Kevin Wilson, a paramedic in Durham, N.C., woke up one January morning in excruciating pain.

“I felt like my chest had imploded,” he recalled. “I told my wife, ‘I’m in trouble.’”

He called 911 and when the paramedics arrived, Wilson was in profound respiratory distress.

“I could talk in barely one-word phrases. I knew something catastrophic was happening,” he said.

When he arrived at the hospital, doctors discovered that Wilson had a massive saddle pulmonary embolism, a blood clot that blocks the main pulmonary artery from the heart where it divides into two main arteries that lead to the lungs. Since blood was completely cut off from one side of his heart, it became enlarged.

Wilson spent 12 hours in the resuscitation room, where the team of doctors and nurses pumped him full of blood thinners, monitored his oxygen levels and made sure the blood clot didn’t move.

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Although he was stabilized, his condition remained uncertain.

“I really didn’t think I would make it through the night,” he said.

For the next three days, he had to stay in bed, immobile, even as tears streamed down his face.  

“They were very concerned that if I moved, that I would dislodge the clot and it would kill me instantly,” he said.  

What is venous thromboembolism?
Venous thromboembolism (VTE) is a disease that includes both deep vein thrombosis (DVT), when a blood clot forms in a deep vein, and pulmonary embolism (PE), when a blood clot breaks off and travels from the leg up to the lungs.

Each year, approximately 900,000 people are diagnosed with VTE, according to the Centers for Disease Control and Prevention (CDC). Between 60,000 and 100,000 people in the US die from VTE and between 10 to 30 percent die within a month of diagnosis.

Men and women have similar risks for a first episode of VTE. In fact, the prevalence of DVT in men was 14 percent, compared to9 percent for women, according to a study in the Journal of Thrombosis and Haemostasis.

Yet when compared to women who don’t have risk factors for VTE, which include pregnancy, oral contraception, and hormone replacement therapy, men are more than twice as likely to have a VTE, according to a study in the journal Circulation.

“The risk of recurrence [for] venous thromboembolism is higher in men. In terms of a yearly risk, it’s about two to maybe two and half times higher,” said Gary E. Raskob, PhD, chairman of ISTH’s World Thrombosis Day steering committee.

Although it’s not clear why, experts believe that it’s likely there is some genetic difference between men and women, Raskob said.

Know your risk
There are several risk factors men have for VTE’s. They include:

  • A height of 6 feet or taller
  • Obesity and a larger than normal waistline
  • Smoking
  • A sedentary lifestyle
  • Sitting for long periods of time or prolonged bed rest
  • Any condition that can increase clotting such as a serious infection or an autoimmune inflammatory disease
  • A family history of blood clots or heart attack
  • Physical trauma or surgery.
  • Age: men over 40 have a higher risk

Men who take testosterone replacement therapy have a 63 percent increased risk, according to a recent study in the journal BMJ.

And simply being admitted to the hospital can increase a man’s risk. In fact, 60 percent of VTEs occur during or within 90 days of a hospital stay, another study in the journal BMJ found.

Symptoms of venous thromboembolism
If you suspect you have VTE, it’s important to recognize the signs early on. You can have swelling, tenderness, redness warmth or pain in your leg or calf, chest pain, shortness of breath, rapid breathing, an irregular heart beat or heart palpitations, lightheadedness or fainting.

“If someone has a clot, [it’s] usually because there’s a blood flow blockage, and so the symptoms are usually pretty dramatic and pretty rapid in onset,” said Dr. Amy Doneen, medical director for the Heart Attack and Stroke Prevention Center in Spokane, Wash., and adjunct professor for Texas Tech Health Sciences Center. “It’s a medical emergency, so people do need to go in and get evaluated.”

How to prevent venous thromboembolism
Although you cannot change your height, you can take other steps that may reduce your risk, such as quitting smoking, exercising, staying well hydrated and avoid sitting for too long. If you do get stuck on a long flight, or even at your computer for an extended period of time, consider wearing support stockings to help prevent blood from pooling in the legs.

When you’re admitted to the hospital for anything, request a VTE risk assessment.

“Ask your doctor, ‘What is my risk of VTE? Should I get preventative measures?,’” Raskob said.

Most importantly, however, is never ignore or brush off your symptoms and call your doctor immediately.

“It’s a minor inconvenience to your time but it can save your life,” Raskob said.

A happy ending
For Kevin Wilson, a combination of flying more than 12,000 miles in a few weeks and surgery to repair a hernia were the factors that lead to his VTE.

Five days after his hospitalization, he was released and had to stay on blood thinners for 18 months. But after he discontinued the medication, he had a small clot in his lungs and was put back on blood thinners for the rest of his life.

Given his line of work, Wilson said although he never took life for granted, now he doesn’t let the little things in life bother him.  

“It reminded me in a more poignant way of how precious life is,” he said. “I’m really grateful to be here.”

Julie Revelant is a health journalist and a consultant who provides content marketing and copywriting services for the healthcare industry. She's also a mom of two. Learn more about Julie at revelantwriting.com.