Heart Failure - Blood Clots in The Leg

Patients with CHF do have a higher rate of blood clots in the leg. This condition is called deep venous thrombosis (DVT). Under normal circumstances, clot formation is a natural process designed to prevent blood loss at the site of a wound.

It involves the production of a threadlike material called fibrin, which forms a meshwork at the site of the wound. Blood cells called platelets are attracted to the fibrin, then clump together to form a clot (also called a thrombus). Blood clots form in the legs of CHF patients because of several factors. These include:

  • Increases in the levels of blood-clotting factors, making the blood more likely to clot (a condition called hypercoagulability).
  • Poor blood circulation, causing the blood to “pool” in the veins of the legs.
  • An injury to the protective lining of the vein.

Some medical conditions that can change these factors and increase the risk of blood clots in the leg include:

  • Congestive heart failure.
  • Being immobilized or living too sedentary a life.
  • Emphysema or COPD.
  • Recent surgical procedures, especially orthopedic procedures like hip replacement surgery.
  • Broken bones and other traumatic injuries.
  • Cancer

Blood clots in the leg are serious. They cause pain, swelling, and make walking difficult. However, the most serious complication of a blood clot in the leg is a pulmonary embolism.

A pulmonary embolism is a blood clot in the lung.When the blood clot in the leg gets big enough, it can break off and flow up the veins in the leg and eventually get caught in the lung. If the clot is small, it will cause chest pain and shortness of breath. If it is large, it can cause severe shortness of breath, low blood pressure, and even death.

Most doctors will try to keep the clot from occurring in the first place by avoiding risk factors, increasing activity, and treating underlying diseases like CHF, cancer, and emphysema. When the risk for a blood clot is high, your doctor may prescribe a blood thinner such as heparin or coumadin.

When treated with these medications, the risk of blood clots decreases significantly; these drugs will keep the blood clot from growing bigger. Eventually the blood clot will either dissolve on its own or it will become hardened and scarred, so that the risk of it traveling into the lungs is eliminated.

Blood thinners are often prescribed for 6 months or more to treat a blood clot in the leg. If the underlying condition that caused the blood clot does not resolve (like immobilization or a broken leg), then the patient may have to take the blood thinners for the rest of his or her life.