Blood clots: Yet another silent killer

Ever heard of thrombosis? The condition is not well-known but it is as deadly as the most common ones. Thrombosis refers to local coagulation or clotting of the blood in a part of the circulatory system. It was a post I came across on Facebook that brought this awful condition to my attention. A certain lady, Christine Gatsinzi Ashimwe, as I learnt later, was expressing her gratitude to King Faisal Hospital, Kigali, for saving her life following a blood clot. A very strong lady as I came to learn when we met, Ashimwe was determined to share her life story for people to gain awareness about the deadly, but preventable condition. The mother of three recalls that it was two days after she had given birth to her third-born when she experienced conditions that caught her attention. She developed a cough and had issues with her breathing, but paid little attention thinking that they could be as a result of the C-section she had had. Two days later the condition worsened. “One night it became intense; I felt really bad I couldn’t sleep I was whizzing from the right side of the chest and I was having shortness of breath. At around 3am I woke up to pump breast milk for the baby, but I couldn’t because I didn’t have the energy. By around 5.30am that very morning I was rushed to the hospital,” Ashimwe narrates. “When the doctor saw me he immediately recognised my condition and acted quickly. I had an ultrasound and they found clots in my leg, they did a chest CT scan and they found there clots too in the right side of my lungs,” she adds. Immediately, she was given treatment and had to stay in hospital for 12 days, four of them on oxygen support. Her life was saved from a condition that has silently claimed many lives. “It’s a silent killer, most people who have clots don’t know about it until they are declared dead. I am a survivor of this dangerous killer,” Ashimwe says. What lies underneath a blood clot? A blood clot can form in any blood vessel in the body; it can end up in the lungs, heart, brain and other locations if it breaks away and travels through the blood, and this movement can lead to serious complications. Ashimwe’s swollen leg and foot following a blood clot. (Donah Mbabazi) There are two types of abnormal blood clot formation: a blood clot that forms in a vein, usually in the leg or pelvis, is known as a deep vein thrombosis; when the clot breaks off and travels from the leg up to the lungs, it is known as a pulmonary embolism, which is a medical emergency that can be life threatening if not treated immediately. Dr Immaculate Kambutse, a resident in internal medicine at King Faisal Hospital, explains that pulmonary embolism occurs when there is blood clot obstructing blood flow in the pulmonary artery, a blood vessel that takes blood from the heart to the lungs. This usually happens when a clot from the deep veins, mostly the leg, commonly known as a deep vein thrombosis, travels through the blood stream to the pulmonary artery or its branches. Blood clots can happen to anyone at any age, though some people do not have any warning signs or symptom. This is the more reason it’s important to know the risk factors and conditions that can prompt a blood clot. “The common symptoms include chest pain especially on breathing in, difficulty in breathing, or coughing up blood and sometimes fever. Some but not all patients may also have a swollen, painful leg,” Dr Kambutse says. She points out that some risk factors include long hours of immobility (prolonged bed rest and long hours of travel, among others), obesity, smoking, and pregnancy. Dr Kambutse adds that some genetic conditions can predispose one to abnormal clotting, cancer and sometimes injury to the blood vessels during trauma. Treatment includes a range of options depending on the status of the patient, which is decided by the treating physician. Sometimes there are no noticeable signs or symptoms of deep vein thrombosis in the leg and when they do occur, warning signs may include; swelling, including the ankle and foot, pain or tenderness, often starting in the calf and there is warmth also. “Pulmonary embolism and deep vein thrombosis can be prevented in people carrying risk factors by avoiding staying in bed or sitting for long hours, preventive medication is given to high risk individuals after assessment by their doctor,” Dr Kambutse says.

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Blood clots: Yet another silent killer