Long-distance travel – whether by plane or car – usually does not cause health problems, but for some people it puts them at risk of developing deep vein thrombosis (DVT), a type of blood clot that can lead to complications.
DVT occurs when a blood clot forms in the deep veins of the body, usually in the leg, pelvis or arm. They can form during long travel and prolonged sitting in a confined space. Long periods of immobility can cause blood to pool in the legs, disrupting normal flow through the veins.
“Fortunately, you can do several things to reduce your risk of blood clots during long trips, such as moving your legs frequently or taking a break to stretch your legs,” says Ankur Chandra, MD, a vascular surgeon at Scripps Clinic Torrey Pines. “Activities like this help to improve the flow of blood in your legs.”
Understanding the signs and risks of DVT is important as well as when to seek care to prevent problems.
DVT can turn serious if a blood clot in the veins breaks off and travels to the lungs causing a blockage. This is known as a pulmonary embolism (PE) and can be life-threatening.
Symptoms of PE include:
- Shortness of breath
- Chest pain
- Coughing up blood
- Faster than normal or irregular heartbeat
- Very low blood pressure
- Lightheadedness or fainting.
“If you have any of these symptoms, seek medical help immediately,” Dr. Chandra says.
Estimates suggest that 60,000-100,000 Americans die of DVT/PE (also called venous thromboembolism), according to the CDC.
About half of the people with DVT have no symptoms at all, but there are several risk factors.
Anyone traveling more than four hours whether by air, car, bus or train can be at risk for blood clots, according to the Centers for Disease Control and Prevention (CDC). The risk is generally very small, but if someone has other risk factors, including:
- Recent surgery or injury
- Slow blood flow due to limited movement, sitting for long time or bed confinement
- Increased estrogen, often caused by birth control pills, hormone replacement therapy or pregnancy
- Heart disease, lung disease, cancer and its treatment or inflammatory bowel disease
- Older age, risk increases after age 40
- Previous blood clot or a family history of blood clots
- Catheter placed in a large vein
DVT often goes unnoticed because symptoms can be very mild. Blood clots typically occur only in one leg.
- Unusual warmth
- Redness or changes in skin color
“If you notice any of these symptoms, seek medical attention. Your doctor will examine your legs and may order an ultrasound test to evaluate blood flow through the veins and check for any blockage or obstruction,” Dr. Chandra says.
Because veins normally do not show up in an X-ray, occasionally a contrast material is injected into the vein to make it visible, and the images are taken as the material flows through the vein.
Medication is used to prevent and treat DVT. Anticoagulants, also known as blood thinners, are most commonly used to treat DVT or PE. In severe cases, the clot might need to be surgically removed.
“Early treatment for DVT is usually very effective,” Dr. Chandra says. “However, people who have one episode of DVT have a higher risk of recurrence.”
Wearing compression stockings may be recommended to help reduce the risk of DVT or treat symptoms. These special stockings put pressure on leg muscles and help blood flow from the legs back to the heart.
Immediate medical attention is needed to treat PE, which can also be treated with medication.
Talk with your doctor if you think you may be at risk for blood clots.
Reduce the risk of blood clots during travel by:
- Knowing signs and symptoms of blood clots
- Move your legs frequently during long trips
- Exercise your calf muscles to improve flow of blood
- Extend your legs straight out and flex your ankles
- Wear compression stockings