Episode 90. Venous Thromboembolism with Dr Sanjeev Chunilal

Venous thrombosis affects more than 30,000 Australians each year and is responsible for over 5000 deaths per annum, this is more than the number of Australians who die from motor vehicle accidents annually. VTE is the third leading cause of death amongst hospitalised patients and patients admitted to hospital are at least 100 times more likely of developing a clot compared to being active in the community-a risk that may be assessed by the modified Wells criteria.

Tellingly 60% of all venous thromboembolisms occur within 90 days of hospitalisation and importantly it is predicted that up to 70% are preventable.
It is also estimated that about 50% of patients with an untreated proximal deep vein thrombosis will develop a symptomatic pulmonary embolus within 3 months …half of these cases are asymptomatic, however, in 25% of cases sudden death is the first symptom.

Whilst 10% of clots form either in the upper limbs or mesenteric system, the vast majority of clots-90%- occur in the lower limbs. Although pulmonary emboli may include fat, amniotic fluid, may be septic or be formed from contaminants such as talc we will restrict discussions in this podcast to blood clots and focus on lower limb clots.

This is potentially a huge subject with multiple factors leading to abnormal clotting, excessive clotting, and subsequent potentially fatal thromboembolism. The more one considers coagulation in both the normal and pathophysiologic states the more fascinating the subject becomes. No wonder then that Associate Professor Sanjeev Chunilal from Monash Health has developed a deep interest and expertise in this subject. Sanjeev completed a clinical and research fellowship in venous thromboembolism at McMaster University Ontario Canada, has published widely and is a member of the International Society of Thrombosis and Haemostasis as well as the Australasian Society of Thrombosis and Haemostasis, please welcome Sanjeev to the podcast.

References:

Associate professor Sanjeev Chunilal: jessiemcpherson.org, monashpathology.org

www.ncbi.nlm.nih.gov: Deep venous Thrombosis: pathogenesis, diagnosis, and medical management,2017

Khan Academy-khanacademy.org

Australian Family Physician VOL 39, No 7 July 2010

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.