A recent article in the financial press (Bloomberg) drew wide attention to inappropriate and excessive use of stents in patients with coronary artery disease (disease in the vessels that supply blood to the heart). Stents are tiny mesh tubes placed in a diseased coronary artery to “prop” it open after a narrowed segment of it has been expanded by a balloon. (more…)
Pulmonary embolism is a common and dangerous condition that occurs when blood clots (deep venous thrombosis, or, DVT) break loose and travel from where the clots formed—mostly the leg veins (or, uncommonly, veins elsewhere)—to the pulmonary arteries, which conduct blood from the heart to the lungs. Sometimes these clots are small and may not cause clinical symptoms, because the surface area of the lungs, when opened out, would cover the surface of two tennis courts! However, occasionally, a pulmonary embolism can be massive and rapidly fatal. (more…)
By Jeffrey M. Levine, MD, AGSF, and Michael Cioroiu, MD, FACS, CWS
Peripheral arterial disease (PAD) of the lower limbs, in which plaque builds up in the arteries that carry blood to the legs, is an often-overlooked cause of poor wound healing, particularly in elderly individuals. While PAD affects roughly 12% to 14% of the general population, it increases with age, affecting up to 20% of patients older than 75 years. (more…)
When patients come to my office with a diagnosis of kidney failure or end stage renal disease (ESRD), most of them are nervous about what the next steps are to continue the activities of their daily life, now that their kidneys are no longer functioning. It is not always a surprise that they have kidney failure; however, the options can be overwhelming.
Guest blog post by Gary Gwertzman, MD, FACS, RPVI
No, it won’t!
The term “vascular laboratory” is unfortunate, because the word “laboratory” can conjure up some unpleasant thoughts. Patients who are sent to a vascular laboratory have little to worry about, and can learn a lot about their vascular (circulatory) health without exposure to harmful radiation or needles. (more…)
Guest blog post by George J. Todd, MD, Chair of the Department of Surgery at Mount Sinai Morningside and Mount Sinai West
Question: A young co-worker of mine (age 28) developed difficulty breathing and pain in his chest. He went to the emergency department and was diagnosed with a pulmonary embolus, a blockage of an artery of his lung, that likely started due to a blood clot in his leg. The doctors told him it was from sitting at his computer for many hours. Is this possible?
Answer: Yes. Prolonged sitting without getting up to move around can lead to deep vein thrombosis (DVT), the formation of a blood clot in a vein deep in the body. DVT typically affects large veins in the thigh and leg but can present in other parts of the body. Once a clot forms in a vein, it can travel to the heart and lungs–forming a pulmonary embolus (PE)–which can cause shortness of breath, chest pain, and even death.
Many people are now aware that DVT can result from prolonged sitting on an airplane (sometimes called “Coach Class Syndrome”) or from being immobile in bed (after surgery, for example). Most people are also aware that obesity, taking oral contraceptives, and some hereditary disorders (such a Factor V Leiden mutation, for example) can predispose a person to DVT and PE.
It may be a surprise to some however, to learn that DVT and PE have also been described in people who have sat for many hours working at a computer. There was even a story reported in several news outlets about a 20-year-old British man who reportedly died of a PE after sitting and playing on his Xbox for many hours without taking a break.
Prolonged sitting can lead to the formation of blood clots in the legs. Once clots form, they can travel to the lungs and cause PE. The Centers for Disease Control and Prevention estimates that as many as 900,000 people may be affected by DVT/PE each year, resulting in between 60,000 to 100,000 deaths. Other studies estimate a much higher figure for both DVT and PE.
The bottom line: It is very important when flying or sitting at a desk, to get up and walk around at least every 60 to 90 minutes. It is also important to wear loose fitting clothing if you will be seated for prolonged periods and to maintain good hydration by drinking water.