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What causes blood clots in veins?

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Posted on Wed, 12 Mar 2014
Question: In September 2013 I was diagnosed with a spontaneous right subclavical vein DVT of 18cm and in October was diagnosed with a small PE in my right lung. Long story short they have no idea how this has come about, given that I am a healthy 29 yr old female with two children. I was put onto warfarin and reassured that I would not get a blood blot again. 2 weeks ago I pushed very hard to get an ultrasound done on my arm because I was feeling the same symptoms when I originally got my blood clots. They have found a 4cm blood clot (newly established) in the Basilic vein. I am concerned that my haemotoligst is quiet relaxed about this issue as I understand it is not life threatening, what my question is how can something like this happen if I am on warfarin?
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Answered by Dr. Indranil Ghosh (37 minutes later)
Brief Answer: need further evaluation Detailed Answer: Hi Thanks for your query. It is unusual for an otherwise healthy individual of your age to have repeated thrombus. If the warfarin dose was OK, as per INR report then even more so. We need to look for any underlying cause, like congenital tendency for clot formation or any immune mediated mechanism. For the time being I think you will be better off on injected low molecular weight heparin. Please discuss these with your hematologist as the underlying cause will dictate the proper treatment. hope I have answered your query. I will be available to answer further follow up queries, if any
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indranil Ghosh (10 hours later)
In your opinion should my situation be treated as urgent - the pain is getting worse even though I am on pain management. The reason I ask is that my heamotologist has told me not to panic that I don't need to see her until 6 march which was my original check up appointment. I have pushed for her to see me this week, especially since my gp is waiting for specialised action plan from her. I have been off work and need to return due to financial pressures. In your opinion would you be sending me to a hospital, pressing specialist s harder or be patient and wait?
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Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer: There is no reason to panic Detailed Answer: Though there is nothing to get panicked, it will be prudent to expedite the process rather than waiting for long. regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1656 Questions

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What causes blood clots in veins?

Brief Answer: need further evaluation Detailed Answer: Hi Thanks for your query. It is unusual for an otherwise healthy individual of your age to have repeated thrombus. If the warfarin dose was OK, as per INR report then even more so. We need to look for any underlying cause, like congenital tendency for clot formation or any immune mediated mechanism. For the time being I think you will be better off on injected low molecular weight heparin. Please discuss these with your hematologist as the underlying cause will dictate the proper treatment. hope I have answered your query. I will be available to answer further follow up queries, if any