Chủ Nhật, 12 tháng 1, 2014

Blood Clots

Blood Clots For any organism to survive flow of blood is essential. Blood flows to and fro from the heart transporting oxygen and other nutrients to various organs of the body. Our heart pumps blood via arteries which carries oxygenated blood to all parts which is returned back in the form of deoxygenated (impure) blood from body parts through veins. Veins send it back to the heart for purification and this process goes on as long as you are alive.

Blood clots occur when normal blood flow is interrupted. Blood vessels carry blood and clotting of blood is a vital process for body metabolism. It is the clotting process that saves you from heavy blood loss during accidents or cut injury. Blood platelets are responsible for clotting of blood. Blood clots are described as thrombus in medical terms. Blood clots are formed as routine repairing process of the body which is very much needed for metabolism. But when clotting of blood occurs unexpectedly it can cause complications.

Depending on the place of blood clot it is treated as mild or serious consequences. Clots that are formed in the veins that supply blood to the brain, lungs and kidneys are very serious and needs immediate medical attention. Blood clots can be diagnosed using radiologic test and ordinary blood clots can be treated using anti-coagulants. Three important materials are included in every blood cell. They are categorized as red blood cells (which carry oxygen to all the cells), white blood cells (which prevent infection) and platelets (that are responsible for clotting of blood).

How does clotting occur?

Whenever there is any injury or cut in your body, blood platelets are immediately rushed to the injured area. This would release certain chemicals to initiate the clotting process which takes place as a series of reaction. Fibrin, a protein is produced during this process that combine together to form a mesh leading to blood clot. Thus heavy blood loss is prevented by this process.

Types of blood clots based on its place of origin :

Blood clots are formed beneath the skin as inside the small veins. They are called phlebitis which may cause moderate pain and swelling. Generally phlebitis will not need any treatment. However when clots develop in large size inside large/deep veins it is called Deep Vein Thrombosis which is serious problem. Often such clots occur in the legs causing intense pain and swelling.

Blood clots that are formed in large sized veins (DVT) will sometimes break away and travel elsewhere. In case it happens to travel till your lungs it can cause pulmonary embolism which is very serious condition. Some blood clots may occur inside the chambers of your heart due to atrial fibrillation. These clots may move towards your brain causing potential complications like stroke and sometimes travel to the arteries thus blocking the blood flow causing heart attack.

Causes :

Several factors and medical conditions can cause blood clots. Medical issues like atherosclerosis, deep vein thrombosis, heart arrhythmias, anti-phospholipid syndrome, peripheral artery disease, polycythemia vera, heart attack, heart failure and factor V Leiden can cause blood clots. If you are obese and have family history of blood clot related diseases then you have more risk for developing blood clots than others.

Types :

Venous thrombosis occurs when blood clots develop in veins. It occurs in people who are immobilized and confined to bed for long term. Since the muscles of the organs are not contracting properly due to lack of movement, it will create a back-pressure pushing the blood back into the heart. These blood clots will develop gradually and sometimes grow into bigger size blocking the entire vein causing serious problem. Venus thrombosis occurs gradually and it will take hours, weeks or even months together to affect the organ.

Arterial thrombus occurs when blood clots happen in arteries. People with atherosclerosis certain substances (called plaque) start blocking the artery leading to narrowing of blood vessel. It can cause life threatening diseases like heart attack or stroke. In case the plaque ruptures inside then it becomes even more serious. Arterial thrombus can develop suddenly causing serious damage to the affected organ. Arterial thrombi can cause acute heart attack or stroke. Blood clots can develop in the bladder which will prevent the normal flow of urine causing urinary retention. When blood clots are formed in the uterus can cause heavy vaginal bleeding (menorrhagia).

Who are at risk?

• People with blood related problems like high blood pressure, high cholesterol, and those with family history of blood clots are prone to get blood clots.

• Smoking habit can increase the risk of developing blood clots.

• People who are confined to bed for certain medical problems and those who are traveling long distances (without any movement) can develop blood clots like DVT.

Symptoms :

The area where blood clots occur may develop inflammation. If the blood clots occur on your legs, it will eventually start swelling and you can feel intense pain. The area becomes tender and warm to touch. These symptoms occur when blood clots occur in the veins.

Arterial clots can block the oxygenated blood to the body tissue making it prone to die (Ischemia). It can cause intense pain and loss of specific function. The symptoms vary according to the area in which arterial clots are formed. For instance the clots developing in the artery of your heart it can cause heart attack. Particular organ that is deprived of oxygenated blood will become weak and will cause decreased sensation. In rare cases, the organ may temporarily be paralyzed.

Tests and Diagnoses :

The doctor will first collect the patient history to know about his health condition and any medical issues. Having a blood clot will not always create a problem but when it occurs in critical locations it poses risk. Physical examination is done after observing the symptoms to detect blood clot. Your doctor will check for swelling and warmth over the affected area. In case the person does not have any sensation in the affected part it can be due to death of tissue caused by arterial thrombosis.

Ultrasound testing procedure is used for confirming the blood clot. Venography is another process wherein a dye is sent into the vein of hand which will be monitored continuously using video X-ray for identifying the area of clot. Blood test results will indicate presence of D-Dimer if blood clots are there. In case the doctor suspects pulmonary embolism (blood clots in lungs) he will immediately do electrocardiogram test. Computerized tomography, serum creatinine test, ventilation perfusion scan are also done for checking pulmonary embolism.

Treatment :

Treatment for blood clots depends on the location and seriousness of the problem. Your doctor will observe the symptoms and consider how far it is serious. Blood clots that develop in the legs or arms will cause swelling of the extremities. You can take ibuprofen or acetaminophen and apply warm compress over the affected leg for getting relief.

If you are diagnosed with DVT (deep vein thrombosis) your doctor may prescribe anti-coagulants for thinning the blood. He would give a shot of Lovenox to thin the blood density that will remove further clotting. Oral pills are given in the form of Warfarin. Sometimes combinations of oral as well as injections are given. However blood results are monitored regularly to avoid any complications.

Blood clots that develop below the knee region have fewer chances to cause pulmonary embolism. Persons detected with pulmonary embolism are given in-patient treatment. He would consider factors like your age, health condition, severity of the symptoms and problems in lung functions. Supplementary oxygen will be started to restore normal oxygen to facilitate breathing. Arterial blood clots are to be treated aggressively. Medications like Alteplase or tenecteplase are given for dissolving the clot. In case of sudden heart attack, after stabilizing the patient, the doctor will do cardiac catheterization for locating the blood clot and normal blood flow is restored.

Complications :

Deep vein thrombosis can sometimes cause life threatening situations when the blood clots get loose to travel into the veins for reaching the lungs. It can arrest the normal lung functions putting life at risk. Arterial thrombosis can cause potential complications like heart attack or stroke.

Prevention :

To prevent blood clots you should be always active. For people who travel frequently by air or car for long distances, should make simple movements for every two hours. In case you have blood pressure or high cholesterol you should quit smoking to prevent getting arterial disease. After discussing with your doctor you can use Lovenox pills or injection in small doses. Wearing tight stockings on your legs will promote smooth blood flow and it will prevent clotting of blood.

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