Advice for patients following a blood clot

Read our guide below about the symptoms of a blood clot and what to do if you have one.

You can also download a PDF version of this patient information by following the link on the right.

What is a blood clot?

Every year, thousands of people in the UK develop a blood clot in a vein. It is known as venous thrombo embolism (VTE) and is a serious medical condition.

VTE is the collective name for:

• DVT (deep vein thrombosis) – a blood clot in one of the deep veins in the body, usually in one of the legs
• pulmonary embolism – a blood clot in the blood vessel that carries blood from the heart to the lungs

How do blood cots happen?

Anyone can get a blood clot, but you’re more at risk if you have:

• been in hospital
• had surgery
• had a serious injury
• been immobile
• are pregnant
• have cancer.

How do you treat VTE?

With anticoagulation. We usually prescribe oral anticoagulation tablets although you may need injections..

How long will I have anticoagulation for?

For DVT a minimum of 3 months and up to 6 months.

For a pulmonary embolism, it’s a minimum of 6 months.

The treatment time can be longer depending on factors such as the severity of the clot.

In certain situations we may recommend lifelong treatment, particularly if we think you have a risk of a second clot.

Can I exercise?

Yes, we recommend gentle exercise such as walking or swimming. A return to your normal exercise routine depends on your physical condition before the clot, and the severity and location of your clot(s).

How important is exercise in rehabilitation for a PE or DVT?

Exercise is highly recommended within the constraints of your physical condition. Exercise increases circulation, reduces symptoms of venous insufficiency, and will make you feel invigorated.

Aerobic exercise may increase lung function after a PE.

Can I travel?

After being diagnosed with a VTE you should avoid flying or extended travel for at least 2 weeks.

In a car, stop every hour or so and walk for several minutes. On a plane, try to:

• sit where you can stretch your legs (for example, an aisle seat)
• get up regularly and walk the aisle(s) for several minutes.

We recommend wearing class 2 compression stockings when travelling. This is really important for flights of 4 hours or more.

You can ask for a class 2 compression stockings prescription through your GP surgery, or you can buy them online. You’ll need to be measured for the correct fitting.

If we think you need compression stockings as part of your treatment, we’ll refer you to the Orthotics department.

Contraceptive pills

If you’ve had a blood clot, we may tell you to avoid the combined oral contraceptive pill, particularly once you stop anticoagulation.  There are many alternative forms of contraception available.  You can discuss these with your GP or sexual health clinic.

Pregnancy

If you become pregnant, you must tell your GP you’ve had a clot. You may need to have Heparin injections during your pregnancy.

What happens when my treatment finishes?

We’ll tell you what to do before you reach the end date of your treatment.

You may need to see the haematology doctors, or you may just be able to stop the anticoagulant.

Will I have a repeat scan?

It’s unlikely you’ll need another scan once you have started anticoagulation. We do not generally repeat scans to see if the clot has gone.

Is it necessary to reduce the dose of anticoagulants?

No. When we tell you, you can stop anticoagulants immediately.

Should I take anti platelets, such as aspirin, after stopping anticoagulants?

Only if your doctor prescribes it.

If you were on anti platelets before starting anticoagulants, talk to your doctor for advice. They can also tell you if it’s necessary to restart them.

Will I still have swelling/pain/aches when treatment finishes?

If you have had a DVT, it’s common to have ongoing swelling in your leg for up to 3 months. If your symptoms continue after the first month of treatment, we may give you compression stockings.

Graduated compression stockings help increase blood flow in the legs and reduce the swelling, so we advise you to continue wearing them. Approximately 30% of people will have long-term swelling in their leg following treatment.

After a pulmonary embolism, it’s common to have shortness of breath and mild pain or pressure in the affacted area. You may have pain when you do physical activity or take a deep breath which may last for months or years. Shortness of breath should decrease with time and exercise.

If this does not improve after 6 months, contact your GP.

What’s the likelihood of developing another DVT or pulmonary embolism?

The majority of patients do not experience a recurrence, but the risk is higher than for those who have not had DVT or a pulmonary embolism.

The degree of increased risk depends upon individual circumstances such as:

• location of the clot
• number of prior clots
• underlying medical conditions.

We’ll discuss your risk of recurrence with you.

What are the warning signs of a new DVT?

Swelling and pain. It often feels like a persistent cramping in your calf.

You may also feel a sensation of fullness/pressure/swelling/ tightness occurs, especially when rising from sitting to standing.

It’s also described as an odd pulling sensation or tingling that does not go away.

What are the warning signs of a new pulmonary embolism?

These include:

• shortness of breath
• fainting
• chest pains (particularly pains that worsen with coughing or change in position)

If you have get any of these symptoms you must contact your GP or out of hours service immediately.

What should I do if I think I have another clot?

If your treatment has finished you’ll need to see your GP, or go to the Emergency Department.

I’m no longer taking anticoagulants but think I have a new clot. Should I restart taking them until I can get medical attention?

No. You should not start taking any medication without discussing with your doctor first. You should get medical advice as soon as possible if you suspect another clot.

If you have any further questions please ask one of the anticoagulation nurses.  We offer a more private space for private and sensitive conversations.

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