Deep Vein Thrombosis and Pulmonary Embolism in Travel

Cause:

With inactivity during travel, blood can slow and become stagnant, and blood clots may develop.

Deep vein thrombosis (DVT, also known as economy class syndrome) is the formation of blood clots in the large veins, usually the legs.

Pulmonary embolism (PE) occurs when a blood clot moves into the lung.

Symptoms include:

Leg or ankle swelling followed by pain, usually in the calf or thigh, and low-grade fever. Both are medical emergencies.

Risk ractors include:

Adults over 40 years old
Airplane travel (typically longer than 4 hours although trips as short as 3 hours have been associated with DVT)
History of cancer
Pregnancy (especially during third trimester and first post-partum month)
Heart failure
Recent surgery (within 4 weeks)
Immobilization (longer than 3 days)
Estrogen contraceptives and/or hormone replacement therapy (HRT)
Obesity
Smoking
Broken leg with cast
Prior history of coagulation disorder

Prevention while traveling:

Do frequent leg and full-body exercises, for example:

Take frequent walks around the airplane.
Point foot upward, clench toes and hold for three seconds. Repeat 10 times with each foot every half hour.
Stand on toes on one foot while on the heel of the other. Alternate. Repeat 20 times.
While sitting, flex your foot up and down, stretching your ankle joint.

Keep your legs uncrossed while seated. Choose a seat with more room. If possible, avoid the inside seat to make it easier to move around the cabin.

If your budget allows, upgrade to fly business or first class for more room and comfort.

Wear comfortable, loose-fitting clothing.

Wear compression stockings, which decrease symptoms and risk of DVT. Sources include: