Opening Remarks: Elizabeth Nabel, M.D., Director, National Heart, Lung, and Blood Institute

Surgeon General's Workshop on Deep Vein Thrombosis

Dr. Elizabeth Nabel was introduced by the Deputy Surgeon General, RADM Kenneth P. Moritsugu.

Dr. Nabel expressed her appreciation to VADM Carmona for being present and calling attention to the serious issue of deep vein thrombosis (DVT). She went on to say that it was an honor for the National Heart, Lung, and Blood Institute (NHLBI) to be cosponsoring the Surgeon General's Workshop on Deep Vein Thrombosis.

Dr. Nabel, seconding the comments of VADM. Carmona, stated that DVT and its fatal complication pulmonary embolism (PE) represent a leading cause of preventable death in the United States. She agreed, as Dr. Carmona observed, that one always looks back at his or her own medical experience and has certain cases that you clearly remember. She recalled that as a senior medical resident at Brigham and Women's Hospital she was sent down to the emergency room see a patient. The gentleman had a little bit of calf tenderness but not much else. She didn't know what to make of it and suggested that he come back the next day. When the patient returned he had florid physical signs of DVT and was sent on for further testing and treatment.

Dr. Nabel said that for her it was an important lesson. The first day she saw this patient the signs and symptoms were diffuse and difficult to recognize. If she had not suggested he come back, she certainly would not have caught it. This experience caused her to have a great deal of respect for DVT and PE in that it is a diagnosis that can easily be missed.

Dr. Nabel stated that she was very pleased that the NHLBI supports basic research in venous biology for the development of improved treatments for venous diseases and their complications. She noted that NHLBI provides research support to a number of the speakers at the workshop and that it was they who would be providing much of the scientific basis for the conclusions reached at the end of the workshop. She also expressed the hope that the workshop discussions would help the NHLBI identify new areas of research related to venous biology, DVT, PE, its complications, and clinical interventions, the kind of basic and clinical science needed to provide the basis for future evidence-based guidelines.

She went on to thank everyone for their participation in the workshop and expressed confidence that their deliberations would help set future directions in the prevention and treatment of DVT. In conclusion, Dr. Nabel said that "with the leadership of the Surgeon General, and through the collaboration of our offices, we are very confident that together we can provide strategies to reduce the mortality of DVT and PE."