1.I have deep vein thrombosis in my leg, why do doctors always ask about cardiopulmonary symptoms during the checkup? A: Deep vein thrombosis mostly occurs in the lower extremities, but its most serious effect is not “leg necrosis”, but “pulmonary embolism”. Patients with pulmonary embolism will experience symptoms ranging from coughing, chest tightness, and panic to severe consequences such as difficulty breathing and cardiac arrest. In a word, deep vein thrombosis is “the disease is in the legs, but the danger is in the heart and lungs”. 2.What is pulmonary embolism? Can pulmonary embolism be predicted? A: Pulmonary embolism is caused by the dislodgement of blood clots in the lower extremities, upper extremities, neck and other parts of the body, which reaches the heart and pulmonary artery in the direction of blood flow. Pulmonary embolism can cause rapid death of the patient. Some patients who are successfully rescued will also develop pulmonary hypertension, which affects heart function. The incidence of untreated lower extremity deep vein thrombosis is as high as 40-50%. Anticoagulation therapy can reduce the incidence of pulmonary embolism, but it does not completely eliminate the risk of pulmonary embolism. It is impossible to predict which patients will develop pulmonary embolism, when they will develop pulmonary embolism, and to what extent they will develop pulmonary embolism. Pulmonary embolism 3.When will the swelling of my legs go down if I have deep vein thrombosis? A: “Swollen legs” is the most important thing in the eyes of most patients because they do not know that “the disease is in the legs and the danger is in the heart and lungs”. Especially according to the traditional Chinese view of health, swollen legs are a very serious matter, even a symbol of a serious illness. Leg swelling does occur in many diseases, involving the heart, lungs, kidneys, liver, endocrine, blood and other systems. However, in patients with diagnosed lower extremity DVT, leg swelling is only a result, a symptom, not the essence of the disease. In patients with DVT, the leg swelling itself is secondary to the importance of pulmonary embolism and other organ damage caused by DVT. Cases of highly swollen legs resulting in necrosis have become very rare in contemporary times. As the thrombus dissolves, or as collateral circulation is established, the patient’s leg swelling will gradually decrease, but it will not disappear quickly. In addition, the early or late start of treatment after the onset of the disease, the intensity of medication, the difference in the effect of medication on different patients, the size of the thrombus, and other factors will affect the improvement time of symptoms. 4.Does the thrombus have to be completely dissolved before discharge? A: The treatment of deep vein thrombosis in the acute stage is mainly aimed at controlling the development of thrombus, reducing the incidence of pulmonary embolism, and reducing the related organ damage. This period is usually treated in the hospital under the close monitoring of doctors. The extent of deep vein thrombosis is much larger than that of myocardial infarction, and the rate of thrombus dissolution is much slower than the latter. Less than one-third of patients are completely dissolved at once during hospitalization. Patients are also discharged from the hospital on anticoagulation therapy for 6-9 months under medical supervision, with a 1-year recanalization rate of about 70%. Therefore, it is not necessary to have the thrombus completely dissolved before discharge. 5.How long does it take to treat deep vein thrombosis? A: The acute phase is usually hospitalized for about 10 days, and the treatment time will be extended if other complications of DVT appear, or in cases with complex etiology, or in cases where the thrombus is difficult to control. After discharge from hospital, anticoagulation therapy must be administered for 6-9 months under the guidance of a doctor, and some patients need to take medication for life. 6.It has been 1 week since I was hospitalized, why is my condition getting worse? A: In the eyes of many Chinese people, hospitalization should get lighter and lighter, not heavier and heavier. This leads to the patient questioning the doctor based on the mantra, “Why is the disease getting worse and worse”. This view is essentially wrong, because many diseases continue to develop after hospitalization, and the symptoms become more and more severe. However, it should never be said that the disease is “getting worse and worse”. On the contrary, if the disease is not treated, it will be worse than the current one. In the process of treating DVT, the risk of pulmonary embolism still exists. In the event of a pulmonary embolism, the condition will worsen. In addition, in many complex cases, such as patients with a combination of undetected tumors, rheumatic immune diseases, infectious diseases, etc., the associated symptoms will become progressively more pronounced and the disease will become more severe. Some blood clots are not easy to control and will also become increasingly severe.