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Hillary Clinton remains hospitalized with blood clot
First Published Dec 31 2012 01:38 pm • Last Updated Dec 31 2012 01:41 pm

WASHINGTON • Secretary of State Hillary Rodham Clinton was admitted to a New York hospital Sunday after the discovery of a blood clot stemming from the concussion she sustained earlier this month.

Clinton’s doctors discovered the clot Sunday while performing a follow-up exam, her spokesman, Philippe Reines, said. He would not elaborate on the location of the clot but said Clinton is being treated with anti-coagulants and would remain at New York-Presbyterian Hospital for at least the next 48 hours so doctors can monitor the medication.

At a glance

A blood clot’s danger depends on where it is

Blood clots like the one that Secretary of State Hillary Rodham Clinton is being treated for following her recent concussion can occur for a host of reasons. How serious a clot is depends on where it is and why it formed. A Clinton aide would not say where hers is located.

WHAT THEY ARE » Blood pools and thickens into a clot after an injury or because of a heart problem, clogged arteries or other condition. Clots also can break off and travel to another part of the body.

WHERE THEY OCCUR » In leg veins (called deep vein thrombosis) or in blood vessels in the neck, brain or lungs. Leg clots are a common risk after someone has been bedridden. Clots are most dangerous when they travel to the lungs, a potentially life-threatening situation, or to the brain, where they can cause a stroke.

RISK FACTORS » High blood pressure, diabetes, birth control pills, pregnancy, stroke, recent surgery, prolonged sitting, circulation problems and heart problems — especially an irregular heartbeat called atrial fibrillation — raise the chances of developing a blood clot.

TREATMENT » Sometimes a blood thinner such as warfarin (Coumadin) is prescribed to allow the clot to dissolve by itself over time and prevent new ones from forming.

— The Associated Press

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"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."

Clinton, 65, fell and suffered a concussion while at home alone in mid-December as she recovered from a stomach virus that left her severely dehydrated. The concussion was diagnosed Dec. 13 and Clinton was forced to cancel a trip to North Africa and the Middle East that had been planned for the next week.

The seriousness of a blood clot "depends on where it is," said Dr. Gholam Motamedi, a neurologist at Georgetown University Medical Center who was not involved in Clinton’s care.

Clots in the legs are a common risk after someone has been bedridden, as Clinton may have been for a time after her concussion. Those are "no big deal" and are treated with six months of blood thinners to allow them to dissolve on their own and to prevent further clots from forming, he said.

A clot in a lung or the brain is more serious. Lung clots, called pulmonary embolisms, can be deadly, and a clot in the brain can cause a stroke, Motamedi said.

Keeping Clinton in the hospital for a couple of days could allow doctors to perform more tests to determine why the clot formed, and to rule out a heart problem or other condition that may have led to it, he said.

Dr. Larry Goldstein, a neurologist who is director of Duke University’s stroke center, said blood can pool on the surface of the brain or in other areas of the brain after a concussion, but those would not be treated with blood thinners, as Clinton’s aide described.

Clinton was forced to cancel Dec. 20 testimony before Congress about a scathing report into the Sept. 11 attack on the U.S. diplomatic mission in Benghazi, Libya, that killed Ambassador Chris Stevens and three other Americans. The report found that serious failures of leadership and management in two State Department bureaus were to blame for insufficient security at the facility. Clinton took responsibility for the incident before the report was released, but she was not blamed.


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Some conservative commentators suggested Clinton was faking the seriousness of her illness and concussion to avoid testifying, although State Department officials vehemently denied that was the case.

Lawmakers at the hearings — including Sen. John Kerry, D-Mass., the Senate Foreign Relations Committee chairman who has been nominated by President Barack Obama to succeed Clinton — offered her their best wishes.

Last Thursday, before the discovery of the blood clot, Reines said Clinton was expected to return to work this week.

The former first lady and senator, who had always planned to step down as America’s top diplomat in January, is known for her grueling travel schedule. She is the most traveled secretary of state in history, having visited 112 countries while in the job.

Clinton is considered a front-runner for the Democratic presidential nomination in 2016, although she has not announced plans to run.

———

AP Chief Medical Writer Marilynn Marchione in Milwaukee contributed to this report.



Copyright 2014 The Salt Lake Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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