Question 1

What is pulmonary embolism and how dangerous is it - could I die from this DVT?

Accepted Answer

Pulmonary embolism (PE) occurs when part of the leg clot breaks off, travels through bloodstream, and lodges in lung arteries, blocking blood flow to lungs - this causes sudden chest pain, shortness of breath, rapid heartbeat, and can be life-threatening. DVT risk of PE depends on clot size and location: small calf DVT has 5-10% PE risk (usually small PE with minimal symptoms), while large thigh/pelvis DVT has 30-50% PE risk (higher chance of large PE). MORTALITY: Untreated DVT/PE has 25-30% death rate, but with prompt anticoagulation, death rate drops to less than 5% - most fatal PEs occur in first 24-48 hours, so starting blood thinners immediately critical. REASSURANCE: If you've been diagnosed with DVT and started on blood thinners, your risk drops dramatically within hours (blood thinners prevent clot growing and breaking off) - by 7-14 days on anticoagulation, PE risk very low. WARNING SIGNS of PE requiring emergency care: sudden chest pain (worse with breathing), severe shortness of breath, rapid breathing/heart rate, feeling faint, coughing up blood - call ambulance (000) immediately if these symptoms develop. Australian context: Call 000 if you suspect PE - ambulance will bring you to emergency department where CT scan (CTPA) confirms PE and doctors start treatment (stronger blood thinners, oxygen, sometimes clot-busting medication for massive PE) - survival rate excellent if treated quickly (95%+ survive).

Question 2

How long will I need to take blood thinners, and what happens if I stop them too early?

Accepted Answer

Blood thinner duration depends on what caused your DVT - PROVOKED DVT (after surgery, injury, pregnancy, immobility): 3 months anticoagulation sufficient (once trigger removed, recurrence risk low 3-5% per year off anticoagulation) | UNPROVOKED DVT (no clear trigger): 3-6 months minimum, then reassess - if first unprovoked DVT and low bleeding risk, may continue indefinitely (recurrence risk 10-15% per year off anticoagulation vs 1-2% on anticoagulation) | RECURRENT DVT (second or third clot): Usually indefinite anticoagulation (recurrence risk very high 15-20% per year off blood thinners) | CANCER-ASSOCIATED DVT: Continue anticoagulation while cancer active (at least 6-12 months, often indefinite). STOPPING TOO EARLY risks clot recurring - studies show stopping at 6 weeks instead of 3 months doubles recurrence risk from 3% to 6% in provoked DVT, and increases risk from 10% to 20% in unprovoked DVT. After completing anticoagulation, your doctor may recommend: (1) D-dimer blood test 1 month after stopping (elevated D-dimer suggests ongoing clotting risk, may restart blood thinners), (2) Thrombophilia screening (test for inherited clotting disorders if unprovoked DVT and family history), (3) Extended surveillance for symptoms (10-15% recurrences occur in first year off anticoagulation, so remain vigilant for leg swelling/pain). DECISION-MAKING: Your doctor weighs recurrence risk (higher with unprovoked DVT, male sex, elevated D-dimer, residual clot on ultrasound) vs bleeding risk (higher with age over 65, previous bleeding, kidney disease, falls) - for borderline cases, you participate in decision (are you comfortable with small recurrence risk to avoid bleeding risk and inconvenience of lifelong anticoagulation?). Don't stop blood thinners without discussing with doctor - sudden cessation can trigger rebound clotting.

Question 3

What is post-thrombotic syndrome and will my leg return to normal after DVT?

Accepted Answer

Post-thrombotic syndrome (PTS) is chronic leg problems developing in 20-30% of DVT patients months to years after clot - caused by permanent damage to vein valves from clot, resulting in poor blood drainage from leg (venous insufficiency). SYMPTOMS: Chronic leg swelling (especially end of day, better after leg elevation overnight), aching/heaviness (worse with prolonged standing), skin changes (brownish discoloration around ankle, dry itchy skin), varicose veins, leg ulcers in severe cases (5-10% of PTS). RISK FACTORS for PTS: Large clot extending into thigh/pelvis (40-50% develop PTS vs 10-15% with calf-only clot), recurrent DVT in same leg, delayed treatment (symptoms more than 1 week before anticoagulation started), persistent leg swelling 1 month after DVT, obesity, older age. PREVENTION: (1) Compression stockings worn daily for 1-2 years after DVT reduce PTS risk by 40-50% (Australian studies confirm benefit) - put on before getting out of bed, wear all day, remove at night - (2) Early mobilization (gentle walking while on anticoagulation promotes blood flow and vein healing) - (3) Weight loss if overweight - (4) Leg elevation when resting. TREATMENT if PTS develops: (1) Graduated compression stockings 30-40 mmHg (stronger than preventive stockings), (2) Intermittent pneumatic compression devices for severe cases, (3) Leg elevation above heart level for 30 minutes 2-3 times daily, (4) Regular walking to activate calf muscle pump, (5) Weight loss and low-salt diet to reduce swelling, (6) Wound care and compression for leg ulcers. PROGNOSIS: Most DVT patients (70-80%) have minimal or no long-term problems - leg swelling and discomfort resolve within 3-6 months as collateral veins develop to compensate for damaged veins. Those who develop PTS usually have mild-moderate symptoms manageable with stockings - severe PTS with ulcers is uncommon (less than 5%). Your leg won't be exactly the same (may have some persistent swelling or visible veins), but most people return to normal activities without significant limitation.

Medical Disclaimer

Blood Clots in the Leg (Deep Vein Thrombosis)

📖What is Blood Clots in the Leg (Deep Vein Thrombosis)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention