Doctors: Does having a venous thromboembolism put you at increased risk for stroke?

[MrMatt]

Just curious if anyone knows. I had genetic testing done, and apparently I have an extraordinarily high genetic risk (71.5%) for both Deep Vein Thrombosii and Pulmonary Embolism. I get what they both are, but my question is, can either of those cause a stroke?

 

[sjwaste]

Actually, I misread. A stroke can cause a pulmonary embolism, but by definition it's a clot stuck in a lung artery. That's not going to cause a stroke.

I think a DVT can cause a PE too. But you probably have bigger problems in general before a piece of either of those breaks up and ends up in the brain.

EDIT: Not a doctor. Just wanted to be one on ATOT.

 

[shiner]

You should probably go ahead and change your avatar to this

 

[allisolm]

I don't know about a stroke, but they can cause death and I would worry about that more.

 

[bobdole369]

I was in a car accident - and I broke my pelvis along with other bones. They installed a Greenfield filter into the superior vena cava.

While not genetically predisposed, that I had a traumatic injury to a series of large bones, combined with a long period of inactivity (2 months of traction) greatly increased my risk for DVT.

An IVC or SVC combined with blood thinners is the usual treatment for such cases, however as yours seems to be chronic, I would not know where to start.

The short answer - they are more likely to cause a pulmonary embolism, but can easily also cause a stroke.

 

[The Sauce]

The answer, yes...if you also have a cardiac defect where there is a hole in the heart (PFO - patent foramen ovale) allowing blood to shunt from the right atrium to the left. That sort of thing is referred to as a "paradoxical embolus." It's pretty rare, but otherwise, no. PE would be the worst you could expect, but that's pretty bad.

 

[BoomerD]

It looks like the general consensus of the ATOT medical community is...you're gonna die.

I wish to be the first to claim dibs on your stuffs.

 

[vi edit]

Strokes typically are in arteries, DVT's are veins. Different plumbing. One's taking blood where it needs to go, the veins bring it back.

 

[redz]

No, DVTs do not cause strokes, but can cause pulmonary embolisms if they break off. Your venous blood (which, by definition, is where DVTs are) travels to your heart, to your lungs to pick up oxygen, back to your heart, and finally to the rest of your body, including your brain, to deliver the oxygen. DVTs cannot physically get past your lungs, so they're unable to reach your brain.

 

[Mr. Pedantic]

Unlikely. DVTs would mostly go on to cause PEs and the like. Not that they're not serious in themselves, of course.

 

[Meghan54]

Strokes typically are in arteries, DVT's are veins. Different plumbing. One's taking blood where it needs to go, the veins bring it back.

Of course, there is one place in the body where an artery carries deoxygenated blood and a vein carries oxygenated blood.

The rule of thumb is ..... arteries carry blood away from the heart, veins return blood to the heart.

 

[CRXican]

I'm reading about PEs in my EMT book right now

I feel bad for you son

 

[Mark R]

No, DVTs do not cause strokes, but can cause pulmonary embolisms if they break off. Your venous blood (which, by definition, is where DVTs are) travels to your heart, to your lungs to pick up oxygen, back to your heart, and finally to the rest of your body, including your brain, to deliver the oxygen. DVTs cannot physically get past your lungs, so they're unable to reach your brain.

In 10-15% of people, there is a hole connecting two heart chambers (this is part of normal development it allows blood to bypass the lungs before birth - but in about 10-15% of people, the hole never fully closes). This is called a PFO.

In these people, a DVT can bypass the lungs and reach the brain. In people who have a stroke, with no risk factors (e.g. smoking, atherosclerosis, etc.) then 40% of those people have a PFO, suggesting that the PFO is a contributor to stroke risk, although not particularly frequently.

In terms of genetic blood clotting disorders, the picture is not that clear. E.g. the Factor V Leiden gene mutation carries a relatively high risk of DVT, but does not appear to increase the risk of stroke (or arterial thrombosis in general) - presumably because the clotting mechanisms affected someone primarily affect veins.

Other genetic mutations vary - e.g. prothrombin 20210A carries only a very weakly increased risk of stroke, whereas its DVT risk is more prominent, whereas defective anti-thrombin III carries a significantly increased risk of both DVT and stroke.

This issue is a complex one, and would need discussion with an expert hematologist specialising in blood clotting disorders, with the precise genetic or thombophilia test results.

 

[rbV5]

No idea.

 

[Slew Foot]

If your tendency towards DVTs is caused by a hypercoagulable state, then yes, you are at increased risk for stroke.

 

[Number1]

I'm reading about PEs in my EMT book right now

I feel bad for you son

Yes he should definitely worry.

 

[TheVrolok]

The answer, yes...if you also have a cardiac defect where there is a hole in the heart (PFO - patent foramen ovale) allowing blood to shunt from the right atrium to the left. That sort of thing is referred to as a "paradoxical embolus." It's pretty rare, but otherwise, no. PE would be the worst you could expect, but that's pretty bad.

This is the short and sweet answer. Odds are if you had a PFO you'd already know about it, but if you're still worried, you can always have a bubble study done (specific type of echo) to make sure.

 

[GasX]

A DVT is a clot in one of the large veins in your legs. If it breaks loose, it travels to your right atrium via the inferior vena cava. From there it travels through the tricuspid valve into your right ventricle where it gets pumped into the pulmonary arteries. Once there the size of the clot becomes important. It will get lodged somewhere.

Small clots block small blood vessels and there are plenty of others to allow sufficient blood flow for it to not cause a problem. In fact, most of us routinely catch tiny clots in our lungs where they are broken down rather quickly.

However, a big enough clot will cause enough of a blockage that very little blood gets through to the alveoli. Thus almost no blood gets oxygen and travels to the left side of your heart which is responsible for pumping to your body (in particular your brain). Consequently, with your left ventricle not getting any blood to pump, your blood pressure plummets and you drop like a stone. Death can be near immediate.

OK, so that is a pulmonary embolism, but can DVTs cause strokes? Actually YES!

When you are in your mother's womb, you have a hole between your right atrium and left atrium called the foramen ovale. It is part of the system that allows you to live off oxygen provided by mom through the placenta and umbilical cord. When your are born, this hole typically closes off within a few days. Depending on the study, between 10% and 25% of them never fully close. Thus, a clot can theoretically enter the right atrium go through the patent foramen ovale (AKA "PFO") and then get pumped straight to your brain. Normally there is a pressure gradient between the left side of your heart and right side that prevents flow in this direction but certain circumstances such as coughing can temporarily causes some flow from the right to the left. In this situation, a stroke could occur but it is unlikely. A person with atrial fibrillation which causes accumulation of clots in your atrium is more likely to experience a stroke of this nature, but that is another TLDR post...