Genetic Basis for Congenital Heart Disease: Revisited: A Scientific Statement From the American Heart Association
Doctors Explain DVT, The Blood Clot Affecting Damian Lillard And Other NBA Players
There has been an acronym going around the NBA world lately that has been raising as many questions as alarms: DVT.
DVT stands for deep vein thrombosis, a type of blood clot that often requires medical intervention. Two superstars, Damian Lillard and Victor Wembanyama, have been diagnosed with a DVT over the last two months.
Wembanyama was ruled out for the remainder of the season by the San Antonio Spurs when DVT was discovered in his right shoulder in February, while Lillard is still attempting to return for the Milwaukee Bucks in the playoffs after doctors found a DVT in his calf in March. Ausar Thompson, the Detroit Pistons' high-flying 22-year-old wing, was diagnosed with a blood clot in March 2024 and did not return to the court until November.
To understand how DVT works and why they appear to be more frequent in the NBA, The Athletic spoke with multiple doctors to learn more about the ailment. Though they were not directly involved in treating these particular athletes, they have extensive experience with the various aspects of treating DVT in other patients.
What is DVT?DVT is a type of blood clot typically occurring in the veins of the arms or legs, though they often have different causes and treatments based on their location. DVT might initially present symptoms of soreness, swelling and heaviness in the affected area, which can be hard to recognize as something more than typical wear and tear for a professional athlete.
"(The symptoms are) not something that athletes would necessarily think is that unusual," said Dr. Cheng-Han Chen, a cardiologist and medical director of the Structural Heart Program at Saddleback Medical Center in Laguna Hills, Calif. "It could just be that in the past, athletes were getting DVT but shrugged it off."
One of the primary risks of a DVT, particularly in the legs, is that the clot can become dislodged and travel to the lungs. This can cause a blockage in an artery known as a pulmonary embolism (PE), which can be life-threatening. The earlier doctors catch DVT, the lower the risk of PE occurring.
"The reason why DVTs are concerning — the lower extremity more so than the upper extremity — is their predilection to migrate to the heart," said Dr. Vinay Badhwar, professor and chairman of the department of cardiovascular thoracic surgery at the West Virginia University Heart and Vascular Institute.
Though there have been three known diagnoses of DVT in the NBA in just over a year, this is far from the first time blood clots have been an issue for NBA players.
Miami Heat star Chris Bosh was ruled out for the remainder of the season in February 2015 when a clot was discovered in his lungs. Bosh then had to retire when another one was found a year later with the NBA ruling the recurrence of a clot constituted a career-ending illness for the then 31-year-old.
There have been more recent examples of players who had DVT and were treated and resumed their careers, such as Toronto Raptors wing Brandon Ingram in 2019 and Los Angeles Lakers center Christian Koloko in 2023. Several other high-profile athletes, such as tennis icon Serena Williams and hockey great Zdeno Chára, also have received DVT diagnoses before undergoing treatment and eventually returning to action.
What causes a higher risk of DVT?Professional athletes can be exposed to heightened risk factors for DVT for several reasons. Frequent plane travel can increase the risk of DVT due to inactivity, though players are not flying drastically more of late than in the recent past. Studies have suggested that taller people are at higher risk of a DVT. But as Dr. Chen noted, player heights have not changed significantly either.
Chen said repeated use of non-steroidal anti-inflammatory drug (NSAID) medications like Advil can increase the risk of DVT, which is notable since professional sports franchises are increasingly treating pain with NSAIDs instead of more dangerous opioids and painkillers.
But the primary concern is that players experience plenty of bruising from contact and push their bodies to the limit. Dehydration, as well as trauma to the extremities from repetitive motions and jumping, also accelerates the risk.
"It's not genetics or familial. It just randomly happens in certain people and is more common in people who have repetitive arm movements," said Dr. Christopher Yi, vascular surgeon at Memorial Orange Coast Medical Center in Fountain Valley, Calif. "Wembanyama, that's probably what's going on with him. In golf, Nelly Korda had that. It's just sort of random people with repetitive arm movements."
Jump shots certainly are among those types of arm motions. Yi notes how overuse of the arm and shoulder can cause the veins in the thoracic outlet to compress, known as thoracic outlet syndrome (TOS). TOS became more widely known in NBA circles when 2017 No. 1 overall pick Markelle Fultz was diagnosed with it when his career sputtered early. This condition can slow down the normal flow of blood through the vein, increasing the risk of clotting.
Though most people associate the components of the shoulder with the ball and socket connection known as the glenohumeral joint, TOS typically occurs in the scalene muscles that run closer to the neck and chest. Important nerves, an artery and a vein run through the area under the clavicle bone and around the first rib, before going down under one of the pectoral muscles near the chest. Compression in these areas can cause TOS and lead to the development of DVT.
How is DVT treated?Treatment for a DVT depends on location. For leg DVT, such as Lillard's, patients begin a blood thinner regimen as soon as possible and then monitor progress from there. Blood thinners are a group of anticoagulant medications that make it more difficult for blood to clot, mitigating the risk of DVT but also making the body more prone to excessive bleeding from contact and cuts. Therefore, players typically are not allowed to play while on blood thinners.
"The recovery is unpredictable and it's all based on how long it takes for the blood clot to dissolve," Chen said. "Depending on the person, the time it takes for the blood clot to resolve could be anywhere from three months to a year. I understand why teams would be like, 'We can't give a timeline.' Because if I were the doctor, I would tell the teams, 'I can't give you a timeline.' "
Because players cannot play on blood thinners, the goal is to diagnose what causes the clotting. Yi explains how the process typically goes for a player in Lillard's situation.
"Trying to figure out what caused it and the length of treatment," Yi said. "Whether he needs to be on blood thinners for long term or short term. I'm not sure about his recovery and prognosis, but I'm not sure players in the NBA can continue competing at a high level while being on blood thinners. Definitely not football. Golf is probably OK, but being on blood thinners in a contact sport can be risky. Any injuries or heavy contact can cause internal bleeding."
There are no clear indications for what will happen in the cases of Wembanyama and Lillard. Both of their teams have expressed optimism for a full recovery, with Lillard attempting to return in time for the playoffs this month.
Bucks star Damian Lillard is still hoping to return for this season's playoffs. (Dylan Buell / Getty Images)For arm DVT, such as Wembanyama's, there are surgical options to relieve the symptoms of TOS. Wembanyama reportedly underwent surgery recently, and there is optimism that he will be ready to play for the French national team at the FIBA EuroBasket tournament at the end of August.
This is the procedure Ingram had in 2019 when he was diagnosed with DVT early in his career. Doctors removed part of his first rib at the very top of his chest to relieve the pressure on the vein, then gave him blood thinners to allow the clot to dissolve. Removing the first rib is not of significant consequence because the area is well protected by the clavicle bone and surrounding ribs, according to Yi.
Once that happens, the patient then stops taking the blood thinners and has a recovery period until their blood coagulation returns to normal and they can be cleared for contact.
"It's a procedure to remove the blood clot, a separate surgery to remove the first rib, and physical therapy after that," Yi said. "That process takes, maybe, up to a year to be back to your competitive form again and usually a full recovery."
Yi calls lower-extremity DVT, such as Lillard's, another difficult situation because it's not usually caused by the compression from the bone, as they are in the arm. Lower-body DVT appears to be more random, so blood thinners are the consensus treatment. The goal is to have those affected on blood thinners until the clot goes away, conduct ultrasounds and other imaging to examine for further clotting once off the medication and then let them ramp up their return-to-play protocol.
"If you get blood clots in the legs and they go to the lung, a PE, the recovery is much different," Yi said. "You need to be on long-term blood thinners. You may have long-standing effects on leg swelling and lung function. That's when you sometimes see athletes have to retire."
Players who are diagnosed with a DVT must continually be checked for further instances of it.
"Once someone has one, then you are a little more worried that it's going to happen again," Chen said. "Because something in their body is prone to cause that blood clot."
Are there more NBA DVT cases?Now that Lillard, Wembanyama and Thompson have all been diagnosed with DVT within about a year of each other, it begs the question of whether there is indeed a rise in blood clots among NBA players.
While experts who spoke to The Athletic acknowledge some of the changes to the game can put more strain on the body — players take more jump shots in the modern game and have to run more than ever — they do not think playstyle changes are the primary cause of an increase in DVT diagnoses. They all point to the increased awareness of DVT, from the athletes to the staff, who help them take care of their bodies.
"I wouldn't necessarily say there's a new epidemic of DVT," Chen said. "It's being diagnosed in a few high-profile players and it's going to come even more to the forefront. When athletes start talking about leg soreness now, trainers are going to think, 'Oh my gosh, do they have a DVT?' Athletes and teams are much more attuned to the possible diagnosis of DVT."
The silver lining for Lillard, Wembanyama and others who have suffered DVT recently: Their cases help ensure that more athletes catch potential DVT before it becomes more serious.
"Chris Bosh was the first big one that we all noticed once he got it," Chen said. "Now, if an athlete has these symptoms, they say, 'Maybe I should get this checked out and tell the trainer.' And then the trainer is now more cognizant of it and more likely to do the testing for it."
(Illustration: Demetrius Robinson / The Athletic; Photos: Thearon W. Henderson, Tim Nwachukwu, Mike Ehrmann / Getty Images)
Are You On Birth Control? Here's What You Need To Know About Blood Clot Risk
Advancements in medicine have given us greater control over our bodies and more choices than ever before. For women, birth control has been especially beneficial, especially for those who do not wish to have children or are not planning currently. There are in fact several options to choose from. However, birth control, or contraceptives, are not free of side effects, some even increasing the risk of blood clots. To help you more with this complication, here's what our expert Dr Archana Dhawan Bajaj, Gynaecologist, Obstetrician, and IVF Expert, Nurture IVF Clinic, New Delhi, has to share.
Also Read: Misconceptions About Contraception Overshadow The Facts: Expert Dispels Common Myths
Does Birth Control Increase Blood Clot Risk?According to Dr Bajaj, birth control has long been recognised to raise the risk of blood clots, which afflict approximately ten out of every 10,000 people on oestrogen-containing birth control each year.
While the US Food and Drug Administration (FDA) has not yet reached a conclusion, it remains concerned about the potential increased risk of blood clots with drospirenone-containing birth control pills.
A review of two 2011 studies confirmed this risk, and preliminary results from an FDA-funded study suggest a 1.5-fold higher risk compared to other hormonal contraceptives. The FDA continues to evaluate the findings.
Explaining the reason behind it, Dr Bajaj says, "Some kinds of birth control produce oestrogen, causing your body to believe you are pregnant and preventing a pregnancy. This additional oestrogen stimulates the creation of proteins that aid in blood coagulation."
"During pregnancy, these clotting factors prevent bleeding during a miscarriage or childbirth. Clotting factors increase the risk of blood clots when using hormonal contraception. The risk varies according to how much oestrogen the body absorbs.
"For the most part, hormonal birth control increases the risk of clots only slightly, and they can use it safely. People with clotting disorders or a history of clots may have a more difficult time deciding whether to use hormonal birth control," she adds.
Which Types Of Birth Control Carry The Highest Risk Of Blood Clot Formation?Blood clots are most likely to occur with birth control methods that contain oestrogen, such as hormonal patches, combination pills, and vaginal rings.
Some people are more vulnerable as a result of oestrogen's ability to raise blood clotting factors, particularly those who have a history of clotting disorders, smoking, or other risk factors.
Because patches absorb more oestrogen than pills, there is a higher risk. Talking to your doctor about non-oestrogen options, such as progestin-only pills or Intrauterine Devices (IUDs), is crucial if you're worried about blood clots.
Also Read: Sweet Potato For Vaginal Health: Gynaecologist Explains Benefits
Warning Signs Of Blood Clots For People Who Take Birth ControlSome of the common warning signs of blood clots birth control users should watch out for include:
According to Dr Bajaj, the danger of blood clots with birth control is minimal, but you can take steps to lower it even more, especially if you are at a higher risk than average for blood clots. Some of the strategies include selecting a birth control technique that is less likely to raise the risk of clots; examples include a levonorgestrel IUD, a progestin-only approach such as the norethindrone pill, and an implant. Additionally, if you smoke, try to quit. Smoking cigarettes raises the risk of blood clots for anyone using combined hormonal birth control.
Some safe alternatives to prevent pregnancy include non-hormonal birth control alternatives like copper IUDs and Phexxi, a vaginal gel.
"Barrier methods of birth control, such as exterior (male) and internal (female) condoms, are an excellent choice since they lower the risk of sexually transmitted infections (STIs)," says Dr Bajaj, adding that diaphragms are put at the top of the vagina to prevent unwanted pregnancy when used in conjunction with a spermicide.
Moreover, cervical caps function similarly to diaphragms; however, they must be fitted by a healthcare expert.
ConclusionIf you're someone who is using a hormonal contraceptive, it is crucial that you check for any signs of blood clot. If you are at a higher risk of developing a blood clot, meaning if you have a history of blood clots, smoke, are obese, and are mostly immobile, you must get yourself assessed by a doctor. Remember, it is crucial to explore your options and consult a doctor for personalised advice.
DisclaimerAll possible measures have been taken to ensure accuracy, reliability, timeliness and authenticity of the information; however Onlymyhealth.Com does not take any liability for the same. Using any information provided by the website is solely at the viewers' discretion. In case of any medical exigencies/ persistent health issues, we advise you to seek a qualified medical practitioner before putting to use any advice/tips given by our team or any third party in form of answers/comments on the above mentioned website.
Living With A Bleeding Disorder
MISSION, Kan., March 31, 2025 /PRNewswire/ -- (Family Features) Many people don't think much about whether their blood is clotting properly. However, when you have a bleeding disorder, a condition that affects the way your body controls clots, it's no small matter.
Photo courtesy of ShutterstockAccording to the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, abnormal clotting can lead to a host of problems, including excessive bleeding after an injury or during surgery.
About 3 million people in the U.S. Have bleeding disorders. Some types, such as hemophilia, are inherited, meaning a person who has it is born with it. Inherited bleeding disorders are caused by certain genes passed down from parents to children. These genes contain instructions for how to make proteins in the blood called clotting factors, which help blood clot. If there is a problem with one of these genes, such as a mutation – a change in the gene's instructions – the body may make a clotting factor incorrectly or not make it at all.
You can also have what's called an acquired bleeding disorder, meaning you develop it during your lifetime. Acquired bleeding disorders can be caused by medical conditions, medicines or something unknown. Your risk of developing a bleeding disorder depends on your age, family history, genes, sex or other medical conditions. If bleeding disorders run in your family, you may have a higher risk of developing or inheriting one.
Symptoms of a bleeding disorder may appear soon after birth or develop later in life and can include:
Excessive bleeding or bruising, such as frequent or long nose bleeds (longer than 15 minutes) or frequent or long menstrual periods
Petechiae, which are tiny purple, red or brown spots caused by bleeding under the skin
Redness, swelling, stiffness or pain from bleeding into muscles or joints
Blood in urine or stool
Excessive umbilical stump bleeding
Excessive bleeding during surgery or after trauma
If you believe you, or someone you care for, may have a bleeding disorder, talk to a health care provider. Your provider may make a diagnosis based on symptoms, risk factors, family history, a physical exam and diagnostic tests. Health care providers typically screen for bleeding disorders only if you have known risk factors or before certain surgeries.
How your bleeding disorder is treated depends on its type. If your disorder causes few or no symptoms, you may not need treatment. If you have symptoms, you may need daily treatment to prevent bleeding episodes or you may need it only on certain occasions, such as when you have an accident or before a planned surgery.
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If you have been diagnosed with a bleeding disorder, it's important to be proactive about your health and follow your treatment plan. To lower your risk of complications:
To learn more about bleeding disorders, visit nhlbi.Nih.Gov/health/bleeding-disorders.
A Story of Bravery, Balance and a Bleeding Disorder
There are lots of things that make Mikey White Jr. Special. He's a dedicated athlete. He's determined, disciplined and optimistic. He's also living with hemophilia, a type of bleeding disorder.
White was diagnosed with hemophilia at age 3 after experiencing several severe bleeding episodes. He had to give up baseball and basketball, his passions, because of the high risk of injuries, but he found competitive swimming – and he's been breaking records ever since.
"Competitive swimming is a noncontact sport, so it complements my hemophilia while still being an intense and rigorous sport," White said.
Being an athlete with hemophilia requires support, White admits. He works with his health care team and coaching staff to make sure he safely manages his condition and balances it with his training. He hopes his story encourages others living with bleeding disorders to accept and appreciate their bodies the way they are.
"It doesn't have to be a limitation," White said.
Michael Frenchmfrench@familyfeatures.Com1-888-824-3337editors.Familyfeatures.Com
About Family Features Editorial Syndicate
A leading source for high-quality food, lifestyle and home and garden content, Family Features provides readers with topically and seasonally relevant tips, takeaways, information, recipes, videos, infographics and more. Find additional articles and information at Culinary.Net and eLivingToday.Com.
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