Question: Three weeks ago I was seen in an ER with a swollen leg and leg cramps. The doctors suspected I had a blood clot and put me on blood thinners. But two days later I had a leg sonogram and nothing was found. What are your thoughts on this? Would the leg sonogram have showed the presence of a previous clot if the clot buster had dissolved it within the two days?
Dr. Hibberd's answer:
This condition is difficult to be sure. Clots usually take weeks to clear. If a clot buster was used, it is possible to have a newer clot clear, but an older clot may not dissolve completely because of fibrin deposition and vessel changes that occur with untreated clots.
The apparent clearing of your clot in two days is certainly a good sign, but you still need to be careful here.
Sometimes clotting conditions fool us. A repeat ultrasound (a sonogram) would normally be in order now, perhaps combined with a highly sensitive so-called "D-Dimer" blood test. An ultrasound of your legs might not show a clot very well even if one may be present, and is not a stand-alone tool. If the initial ultrasound is negative, additional ultrasounds should be done over time, along with a D-dimer test to exclude the presence of a clot.
Blood clot treatment for deep vein clots usually continues for at least three months because of the elevated risk of a life-threatening pulmonary embolism (often a cause of sudden death). More superficial clots can be uncomfortable, but are not usually life threatening or a cause of pulmonary embolism or sudden death.
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