The Downside of Low Heart Rate: Athletes Who Get Blood Clots
DVT in endurance athletes sounds unlikely, but certain lifestyle factors put them at risk for the dangerous blood clot disorder.
By Beth W. Orenstein
Medically Reviewed by Farrokh Sohrabi, MD
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When a sports icon has a life-threatening medical condition, it makes headlines. That's what happened when tennis superstar Serena Williams developed deep vein thrombosis (DVT).
As the name implies, DVT refers to a blood clot that forms in a vein deep in the body, often in the lower leg. The life-threatening part stems from the possibility that the clot will travel through the blood and lodge in blood vessels in the lungs, blocking the flow of blood. At that point it's called a pulmonary embolism and could be fatal. Together, the two conditions are called venous thromboembolism (VTE).
No one's immune from developing a DVT, including young, fit, and healthy athletes. But there's also no research to suggest that athletes are at higher risk for deep DVT than the general population. Nonetheless, that wouldn’t surprise Jack Ansell, MD, chairman of the department of medicine at Lenox Hill Hospital in New York City and a member of the National Blood Clot Alliance Medical and Scientific Advisory Board.
Athletes and Risk for DVT
A number of factors could explain why athletes may be at greater risk for DVT, especially endurance athletes who run marathons, bike hundreds of miles, or compete in triathlons:
The need to travel long distances.Competitions are held across the globe, requiring top athletes to take very long flights to participate. Sitting cramped in a plane seat for more than four hours raises your risk of DVT. The longer you don’t move, the greater your chances of developing a blood clot deep in the veins of your legs. Inactivity before and after a competition also could contribute to risk.
Dehydration.Despite taking in water or sports drinks, it’s still easy for high-performance athletes to sweat profusely and become dehydrated when participating in strenuous activity. Dehydration decreases plasma, the liquid portion of the blood, and increases blood’s thickness or stickiness. The thicker your blood, the more likely clots will form.
Injury.Despite training and conditioning, competitive athletes can have accidents and break bones or suffer other injuries in a fall or crash. Any injury to a vein or a severe muscle injury can increase the risk for developing DVT. So can the very same cast or brace needed to stabilize a broken bone — it makes you less mobile, and that allows your blood to pool.
Low heart rate.People who exercise extensively can have a lower-than-average heart rate and blood pressure. Both could be risk factors for blood pooling and clotting. A resting heart rate of less than 60 beats a minute, though not dangerous in and of itself, may increase the risk for formation of a clot.
Hormones.Female athletes may use hormone contraceptives during training and around competitive events to avoid menstruating at an inopportune time. VTE is rare, but taking birth control pills that contain estrogen or estrogen and a progestin have been shown to increase the risk.
RELATED: Bouncing Back After Deep Vein Thrombosis: Kelsey Minarik’s Story
Recognizing and Treating DVT
Dr. Ansell said everyone, not just athletes, should be on the lookout for signs and symptoms of DVT, including:
- Swelling in one of your legs
- Pain or tenderness in your leg
- Cramping that doesn’t ease with ice or stretching
- A leg that is warm and reddish or bluish
Symptoms of pulmonary embolism include:
- Shortness of breath or inability to catch your breath with exertion
- A racing heart
- Cramping in your side or chest
- An unexplained cough or cough with bloody mucus
- Feeling faint or dizzy or lightheaded
Athletes who do develop a DVT and are being treated typically need to refrain from training for at least a month to give the clot time to dissolve. Those put on a blood thinner should avoid contact, high-intensity sports in which injury is more likely. And it's important to be especially careful not to fall when doing activities like running, cycling, or skating.
Preventing DVT in Athletes
How do you lower your risk for DVT and PE and still keep yourself in the game?
Consider these preventive measures:
Take a daily aspirin.If you have risk factors such as a personal or family history of DVT, ask your doctor whether you're a candidate for a daily aspirin, which works as a blood thinner.
Drink lots of water.Be vigilant about staying hydrated. Drink water before and after training. Also limit caffeine and alcohol, which have a diuretic effect and can foster dehydration.
Take travel precautions.When traveling long distances, whether by car, train, or plane, wear compression stockings and avoid sitting for too long. Instead, stretch and walk around periodically. Also, don’t sit with legs crossed at the knees or ankles.
Listen to your body.Don’t assume that a pain in your leg is just a pulled muscle. If it persists or something seems off, call your doctor.
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