Deep Vein Thrombosis (DVT) or Economy Class Syndrome

In October 2000 an apparently healthy 28-year-old woman died from a pulmonary embolism shortly after she stepped off a 20-hour Qantas flight from Australia to England. There was a lot of publicity regarding the health dangers of long haul flying shortly after and most airlines began printing warnings for Deep Vein Thrombosis (DVT) on its tickets.
Since then there has been very little said about DVT but people do need to be aware that it can be a real health hazard, particularly for Australians who need to endure long flights. So we thought we'd provide a little refresher course.

DVT What is it
DVT is basically the occurrence of blood clots forming in the deep veins of the legs. It can become fatal when the clots break off and travel to the heart and lungs. This condition is called Pulmonary Embolism.
Pulmonary Embolism symptoms usually do not appear until after a few days or more after the flight and is often misdiagnosed as a heart attack, chest cold or other conditions.

What causes it
DVT most often occurs as a result of poor or sluggish blood circulation and/or increased "stickiness" of the blood.

Who is at risk
Anyone who is immobile for long periods of time. This includes air, bus and train travel as well as sitting in theater seats, desks, periods of prolonged bed rest and standing in one place for long periods of time without moving. For modern-day air travellers cramped airline seating, long haul flights, the change in cabin air pressures and the ever decreasing distance between the seats are all factors which have increased the risk of DVT deaths.

HIGH risk factors
Factors that increase the "stickiness" of the blood and/or decrease the circulation are:

• Wearing tight, restrictive clothing
• Smokers
• Obesity
• Age (over the age of 40)
• Pregnancy or the contraceptive pill
• A past history and/or family history of DVT
• Recent surgery, particularly in the legs.
• Inflammatory diseases
• Cancer
• Cardiovascular disease
• Liver disease
• If you think you may be at high risk, consult your doctor before the flight as there is prescription medicine available for the prevention of DVT.

Things you can do to reduce the risk

• Wear loose comfortable clothing that doesn’t restrict your circulation.
• Move/exercise your legs as much as possible during the flight to increase the blood circulation.
• Wear specialised compression stockings/knee high stockings.
• Take some aspirin to thin the blood.
• Keep your legs elevated when possible.
• Drink plenty of water.
• Avoid excessive alcohol.

Symptoms
DVT can occur without any symptoms (especially if the clots form in a vein other than in a leg or arm)
When symptoms do occur they include:

• Redness, swelling and heat in the area over the path of a deep vein.
• A deep vein feeling like a hard piece of rope or cord.
• Pain or discomfort over the path of a deep vein . The pain is usually located in the calf or behind the knee and may get worse if the person stands or walks - it is usually relieved by resting with the painful leg/s raised.
• Discoloration or ulceration of the skin over a deep vein.
• Symptoms of Pulmonary Embolism are shortness of breath, pain, fainting. Often fainting is the first sign. Sudden death can also occur without any symptoms.

What to do
In flight - alert Cabin Crew!
Get yourself to a hospital and tell them you’ve been on a long haul flight.
For more information on DVT visit http://www.airhealth.org/