EP166: Deep Vein Thrombosis & Factor 5 Leiden

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Podcast Summary Introduction Dr. Warrick Bishop is a practicing cardiologist and author dedicated to educating patients about heart health and helping them make informed medical decisions. In this episode, Dr. Bishop provides a comprehensive overview of deep vein thrombosis (DVT), pulmonary embolism (PE), and Factor V Leiden—a hereditary clotting disorder—explaining their causes, symptoms, diagnoses, and treatments. The episode aims to help listeners understand these serious but manageable cardiovascular conditions. Key Takeaways: DVT (deep vein thrombosis) is a blood clot in the deep veins, most commonly in the legs, causing swelling, pain, and redness that can be diagnosed through ultrasound. DVT is treated with blood thinners to prevent clot extension rather than dissolve it, as the body naturally breaks down clots over approximately three months. PE (pulmonary embolism) occurs when a clot from a DVT travels to the lungs and becomes lodged in lung blood vessels, which can be life-threatening and requires immediate diagnosis via CT pulmonary angiogram. Risk factors for DVT include immobility, pregnancy, obesity, smoking, oral contraceptive use, surgery, cancer, and advanced age. Approximately 30% of DVT and PE cases have a hereditary cause, with Factor V Leiden being the most common genetic clotting disorder. Factor V Leiden is a genetic mutation where the blood protein Factor V doesn't properly interact with protein C, the body's clot-preventing mechanism, increasing clot formation risk. PE symptoms include sudden shortness of breath, rapid heartbeat (tachycardia), collapse, and occasionally coughing up blood, requiring urgent treatment with blood thinners and sometimes clot-busting drugs. Long-term blood thinner therapy lasting six months to life is recommended for PE patients, particularly those without a clear provocation for their clot. Factor V Leiden requires special consideration in young patients with clots, pregnant women, and those using estrogen-based oral contraceptives, with smoking strongly discouraged. Interestingly, Factor V Leiden has not been linked to stroke risk in non-valvular atrial fibrillation, despite its association with increased clotting tendency.