The blood clot that has put Secretary of State Hillary Rodham Clinton in the hospital is probably in her leg and is most likely a consequence of resting after the concussion she suffered from fainting 2[SUP]1[/SUP]/ [SUB]2[/SUB] weeks ago.
The State Department hasn’t revealed the location of the clot, information that is crucial to understanding the risk to Clinton, 65. If the clot is in one of the blood vessels of her brain, it would be an unusual consequence of the fall she suffered at home Dec. 13, reportedly after becoming dehydrated from an intestinal virus. It could even have been the cause of the fall.
Video
Secretary of State Hillary Rodham Clinton is hospitalized in New York with a blood clot. She is expected to stay in the hospital for 48 hours.
More fiscal cliff coverage
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But that’s not likely, medical experts said Monday. Clinton’s history of a blood clot in her right leg in 1998 and the anticipated length of her hospital stay — reportedly 48 hours — suggests the clot is not in her head, lungs or heart.
“I think what most people are speculating is that she has a deep venous thrombosis, most likely in her leg,” said Allen J. Taylor, chief of cardiology at Georgetown University Medical Center.
If that is the case, Clinton is probably being treated with an injectable blood thinner to prevent the clot from growing. Once stable, she would be switched to an oral anticoagulant, which she would take for at least six months.
The chief hazard of a blood clot in the leg is its potential to break off and travel downstream through the heart and into the lungs. Known as a pulmonary embolism, that event can cause severe respiratory distress or sudden death.
Being immobile for a prolonged period, especially in bed, is the most common known cause of deep venous thrombosis, also known as DVT. That is why many hospitalized patients and nearly all recovering from surgery get a preventive dose of anticoagulant medicine until they go home.
“You can get a DVT at home just as easily as you can in the hospital if you are just spending time in bed,” Taylor said. “At home or in the hospital, the risks are the same if you are immobile.”
How active Clinton has been in the past two weeks is not known. However, as a result of her fall and concussion, she decided not to testify before Congress on Dec. 20 about the Sept. 11 attack on a U.S. diplomatic compound in Benghazi, Libya. She also did not appear at the White House on Dec. 21, when President Obama introduced Sen. John F. Kerry (D-Mass.) as his nominee to succeed her.
A previous DVT also increases a person’s risk of getting another one because the normal architecture of the vein is often damaged, even long after the body reabsorbs the clot. Dehydration increases the risk of a clot by making the blood more viscous.
Sitting in airplanes for longer than six hours also appears to increase the risk of clots in the legs. Clinton, who has visited more countries than any previous secretary of state, is a legendary air traveler.
Preventing DVTs in hospitalized patients has been a preoccupation of medicine for the past two decades. Research showed they are more common than was once believed, their consequences can be disastrous and nearly all can be prevented. The desire to prevent them is largely responsible for the practice of getting surgical patients out of bed and either sitting or walking within 24 hours of operations.
Blood clots occasionally occur spontaneously in the brain’s large veins, a condition known as cerebral venous sinus thrombosis. It is distinctly rare in adults — about four cases per million people — and can cause many problems, including seizures and a dangerous increase in pressure inside the skull.
Cerebral thromboses are often treated with anticoagulation, although that strategy is not without risks.
The State Department hasn’t revealed the location of the clot, information that is crucial to understanding the risk to Clinton, 65. If the clot is in one of the blood vessels of her brain, it would be an unusual consequence of the fall she suffered at home Dec. 13, reportedly after becoming dehydrated from an intestinal virus. It could even have been the cause of the fall.
Video
Secretary of State Hillary Rodham Clinton is hospitalized in New York with a blood clot. She is expected to stay in the hospital for 48 hours.
More fiscal cliff coverage
Post PoliticsLIVE BLOG | From the Senate floor to the White House, stay with us for updates on negotiations.
Lori Montgomery, Paul Kane and William Branigin Democrats offer a key concession on increasing taxes for higher-income households.
Ezra Klein WONKBLOG | As some see it, they've broken Obama’s hardline position on taxes and the debt ceiling.
Chris Cillizza and Aaron Blake THE FIX | Deal or no deal, Congress dropped the ball on the fiscal cliff.
David A. Fahrenthold and Felicia Sonmez John A. Boehner could lose his gavel or leverage if he can’t control results in the House of Representatives.
Start here for an explanation of wonky terms and key issues in the looming fiscal crisis.But that’s not likely, medical experts said Monday. Clinton’s history of a blood clot in her right leg in 1998 and the anticipated length of her hospital stay — reportedly 48 hours — suggests the clot is not in her head, lungs or heart.
“I think what most people are speculating is that she has a deep venous thrombosis, most likely in her leg,” said Allen J. Taylor, chief of cardiology at Georgetown University Medical Center.
If that is the case, Clinton is probably being treated with an injectable blood thinner to prevent the clot from growing. Once stable, she would be switched to an oral anticoagulant, which she would take for at least six months.
The chief hazard of a blood clot in the leg is its potential to break off and travel downstream through the heart and into the lungs. Known as a pulmonary embolism, that event can cause severe respiratory distress or sudden death.
Being immobile for a prolonged period, especially in bed, is the most common known cause of deep venous thrombosis, also known as DVT. That is why many hospitalized patients and nearly all recovering from surgery get a preventive dose of anticoagulant medicine until they go home.
“You can get a DVT at home just as easily as you can in the hospital if you are just spending time in bed,” Taylor said. “At home or in the hospital, the risks are the same if you are immobile.”
How active Clinton has been in the past two weeks is not known. However, as a result of her fall and concussion, she decided not to testify before Congress on Dec. 20 about the Sept. 11 attack on a U.S. diplomatic compound in Benghazi, Libya. She also did not appear at the White House on Dec. 21, when President Obama introduced Sen. John F. Kerry (D-Mass.) as his nominee to succeed her.
A previous DVT also increases a person’s risk of getting another one because the normal architecture of the vein is often damaged, even long after the body reabsorbs the clot. Dehydration increases the risk of a clot by making the blood more viscous.
Sitting in airplanes for longer than six hours also appears to increase the risk of clots in the legs. Clinton, who has visited more countries than any previous secretary of state, is a legendary air traveler.
Preventing DVTs in hospitalized patients has been a preoccupation of medicine for the past two decades. Research showed they are more common than was once believed, their consequences can be disastrous and nearly all can be prevented. The desire to prevent them is largely responsible for the practice of getting surgical patients out of bed and either sitting or walking within 24 hours of operations.
Blood clots occasionally occur spontaneously in the brain’s large veins, a condition known as cerebral venous sinus thrombosis. It is distinctly rare in adults — about four cases per million people — and can cause many problems, including seizures and a dangerous increase in pressure inside the skull.
Cerebral thromboses are often treated with anticoagulation, although that strategy is not without risks.