Heart defect could add to 'economy class' clot danger

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Heart defect could add to 'economy class' clot danger
By Arianne Aryanpur, USA TODAY

Take steps to reduce risk  If you travel long distances by air, you should=
=20
take common-sense measures to reduce the likelihood of blood clots," says=20
Stephen Borron, associate clinical professor of emergency medicine at=20
George Washington University in Washington, D.C. Nearly a third of adults=20
may have an undiagnosed heart defect that increases their chance of a=20
stroke if they fall victim to "economy class syndrome." Researchers say the=
=20
small opening between the heart's chambers, called a patent foramen ovale=20
(PFO), provides a passageway for blood clots from the right side of the=20
heart to the arteries that lead to the brain. They estimate that 30% of the=
=20
population has this asymptomatic opening, which in most people closes after=
=20
birth.

The American Academy of Neurology study adds another degree of danger to=20
deep vein thrombosis (DVT), a condition in which blood clots form in the=20
legs after long periods of inactivity. DVT has been nicknamed economy class=
=20
syndrome because airline passengers have suffered clots after long flights.=
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Though most clots dissolve in the bloodstream, those that don't can lodge=20
in the legs, causing swelling, pain and redness. In rare and sometimes=20
fatal cases, a clot travels to the lungs, lodges in an artery and mimics a=
=20
heart attack with symptoms like shortness of breath and chest pain. "Blood=
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clots coming from the legs that make their way to the brain are the rarest=
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case, and can only occur if a person has a PFO," said Stephen Borron,=20
associate clinical professor of emergency medicine at George Washington=20
University in Washington, D.C., and the study's author. Passengers who=20
frequently travel long distances or know they're at higher risk for blood=20
clots can receive a PFO test as part of routine cardiovascular tests.

For eight years, researchers studied passengers who arrived at Charles de=20
Gaulle Airport in Paris after long flights. A very small percentage had a=20
stroke caused by a blood clot but even so, each person in that small group=
=20
had a PFO. Experts estimate there are several hundred cases of DVT each=20
year, but because most passengers don't seek treatment until days after=20
flying, they're often misdiagnosed, which leaves the actual number unclear.=
=20
Most passengers don't even know DVT exists =97 75% of Americans, in fact,=20
according to a study this year by the American Public Health Association=20
and Centers for Disease Control and Prevention. That was true for Shawn=20
Blansett, who two years ago took a long nap on a flight from Houston to=20
London. Neither he nor his wife, Modesta, was aware of DVT or that Shawn,=20
36 at the time, had a PFO.

Four hours into the flight, Blansett woke up to see the cabin spinning, the=
=20
result, doctors say, of a blood clot that had traveled from his leg to his=
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brain. He was rushed to a hospital in London, where doctors were forced to=
=20
remove a portion of his cerebellum, the part of the brain responsible for=20
coordination. The father of two was left permanently disabled. He and his=20
wife have filed a lawsuit against Continental Airlines claiming that they,=
=20
and other passengers, weren't warned about the risks of DVT. "What the=20
general population needs to know is that ... they need to try and prevent=20
these blood clots regardless of age or cardiovascular condition," said=20
neurologist Edgar Kenton, chief of cerebral vascular diseases at Thomas=20
Jefferson University in Wynnewood, Pa. Blood clots can form after prolonged=
=20
periods of immobility anywhere, not just on planes. Complications of DVT=20
claimed the life of NBC's David Bloom in April. He had been sitting in an=20
armored vehicle for hours at a time covering the war in Iraq.


Experts recommend the following preventive measures to reduce the risk of=20
deep vein thrombosis:
  Stay well hydrated; avoid caffeine and alcoholic beverages.
  Starting three days before the flight, take one aspirin a day.
  Move around periodically; take a walk in the aisle.
  While seated, flex your ankles, pump and massage your legs.
  Wear compression stockings that prevent blood from pooling in your legs.

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