No Respecter of Position: Hillary Clinton Hospitalized with Blood Clot

US Secretary of State Hillary Clinton

Secretary of State Hillary Rodham Clinton was admitted to a New York hospital on Sunday after being diagnosed with a blood clot. The clot was discovered on a follow up exam according to her State Department spokesman, Philippe Reines.

As of Monday (12/31/12) Reines, had not elaborated on the location of the clot. He did say, ‘Clinton was being treated with anti-coagulants and would remain at New York-Presbyterian Hospital for at least 48 hours.’

Clinton, 65, is considered by some to be the Democratic front-runner for the presidential race in 2016. She has been a focus of reports related to her testimony before Congress on the Benghazi attacks. Her testimony has been delayed by medical problems including gastrointestinal ‘flu’, dehydration, fainting, head injury and a concussion.

It is unclear if Clinton’s most recent health scare interpreted her planned vacation in the Dominican Republic over the holidays. As recently as Thursday, Reines said Clinton was expected to return to work this week.

By remaining in the hospital for at least 48 hours, “Her doctors will continue to assess her condition, including other issues associated with her concussion,” Reines said in a statement. “They will determine if any further action is required.”

Since the State Department has not released details of her condition there has been media speculation about her diagnosis and condition. Most recent reports indicate that she has a blood clot between her skull and her brain.

The diagnoses being discussed include a DVT (thrombosis in the deep veins of the legs). Clinton has a prior history of a DVT. Other potential diagnosis includes a subdural hematoma (collection of blood between the skull and the brain) Subdural are a complication of a head injury such as Clinton’s recent concussion.

A rarer diagnosis includes a dural venous sinus thrombosis which may coexist with a DVT. Similar factors increases ones risk for both: dehydration, tendency to form blood clots (inherited or acquired), recent injury or trauma and immobility.

Since her spokesman stated she was being treated with blood thinners her diagnosis is most likely recurrent DVT or a dural venous thrombosis and not a subdural hematoma since blood thinners would be contraindicated in that condition. At this time her diagnosis is speculation.

Clinton is at an increased risk for DVT. DVT is more common after being bedridden, as Clinton may have been. Her history of DVT and her grueling travel itinerary as Secretary of State, also, increases her risk.

Historically DVT has been treated with three to six months of blood thinners to allow them time to heal and to prevent further clots from forming. Trends in the treatment of DVT include out-patient management when stable and graduated compression stockings to prevent long term swelling, pain and skin changes in the involved leg.

Clot busting drugs in certain patients lowers the risk of long term damage to the deep veins in the legs or lungs. In patients like Clinton with a head injury or recent surgery these drugs are contraindicated.

Clots that move from the leg to the lungs pulmonary emboli (PE) are more serious. Over 100,000 Americans die each year from PE. If blood thinners are contraindicated or do not prevent new DVT or PE a ‘filter’ can be placed in the vena cava to prevent new emboli from reaching the heart and lungs.

Additional information from Clinton’s spokesmen concerning her recovery is anticipated over the coming days. This breaking news serves as a reminder of the seriousness of DVT and PE and their impact on Americans health.

How can you prevent blood clots?

Fortunately there are things you can do to help yourself.

  • Remember to exercise frequently (get up and walk especially when flying)
  • Elevate your legs when sitting
  • Wear graduated compression socks
  • Maintain a healthy weight

If you have a family or personal history of blood clots get tested to determine if you have an inherited or acquired tendency to clot. And if you have leg pain, swelling, calf tenderness or unexplained shortness of breath or chest pain seek medical attention immediately.

If you have any questions please call Vein Specialists of the South (800-764-3280).

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