Thrombosis is a medical condition in which the blood clots in the blood vessels of the body. It could be an artery or a vein. Thrombosis is just the general medical term for the clot of blood in a blood vessel. There are different types of thrombosis based on the location, type of blood vessel, etc. The clot itself is called a ‘thrombus’. In certain cases, the blood clot breaks off and travels in the bloodstream. ‘Thromboembolism’ is the term used to explain the phenomenon.
‘Thrombosis’ in Greek refers to a clot or lump (generally in the terms of curdling of milk). All medical terminologies referring to a blood clot is thus derived from this word.
Thrombosis can happen anywhere in the body, any blood vessel.
Symptoms of Thrombosis:
Symptoms of thrombosis can vary from person to person, but the general symptoms are enumerated below.
If there has been a clot formation in the deeper veins, the symptoms that could ensue from this Deep Vein Thrombosis (DVT) are swelling, mild to severe pain and at times redness.
Arterial blood clots could have less intense symptoms like mild pain and blanching of colour locally. Generally, arterial blood clots are seen in arms or limbs.
Thrombosis in the coronary artery has to be treated at the earliest as these are fatal. Some tell-tale symptoms of a heart attack are chest pain and uneasiness radiating outwards from the left side of the chest, shortness of breath, consistent indigestion, bouts of nausea and sudden sweating. If the patient is also suffering from diabetes, there may be case specific symptoms to watch out for. Majority of the times, the clot is generally composed of hard cholesterol which hampers the flow of blood.
A pulmonary embolus is a thrombosis in the lungs. The symptoms which could be important pointers are rapid and sudden changes in the breathing pattern, chest pain, sudden shortness of breath, etc. In severe cases, the patient can also feel a catch like a symptom in the chest.
If there is a thrombosis or embolus in the brain region, there can be varied symptoms based on which region of the brain is affected. The symptoms could be slurred speech or vision, weakness and paralysis symptoms in one part or on one side of the body. This is due to the reason that, that particular part of the brain does not get the necessary oxygen supply due to a clot. Thus the aberrations. The sooner it is treated, the better, because the conditions get worse with time and can also end in a stroke.
– Symptoms pointing to mesenteric ischemia: when the artery supplying to the intestines has a thrombotic mass, the generally seen symptoms are abdominal cramps, pain, pulsating feeling, nausea and presence of blood traces in the stools.
– Symptoms of Femoral Vein Thrombosis: When a clot is formed in the femoral vein, the common symptoms are: Redness in the local area, swelling or bouts of pain.
– Paget-Schroetter Syndrome (PSS): This syndrome is generally seen in young and healthy people who use their arms, especially the upper muscle groups a lot. Activities like basketball, cricket, etc. require this kind of muscle movement. When the muscle squeezes the vein, the friction causes a thrombosis condition in the area. It causes redness, swelling and pain. If not treated in the early stages, it can lead to a series of complications.
– Symptoms of Thrombosis of Superior Vena Cava: This category of thrombosis is formed due to the insertion of the catheter into the Superior Vena Cava. This vein carries medicines into the body. In mild cases, the thrombosis heals but the more complex cases require the catheter to be removed and the condition to be treated with blood thinning agents.
Symptoms pointing at Thrombosis of the Jugular Vein include neck pains and cramps. Generally, in most cases, if Juglar vein thrombosis is left untreated, it can get detached and flow to the lungs. This can lead to complexities like PE (Pulmonary Emboli).
– Cavernous Sinus Thrombosis Symptoms: This vein is located behind the eyeball. Symptoms of the Cavernous Sinus Thrombosis involve pain behind the eye sockets, blurred vision and loss of control over eye movements. In complex cases, bulging and watering of the eyes can be seen.
Symptoms of Renal Vein thrombosis is generally associated with lower back ache and traces of blood components in the urine.
Causes of Thrombosis:
Thrombosis can be caused by various reasons depending on the site of the clot and the local physical conditions.
Clots tend to form in areas where there is a breakage in the lining of the wall of the blood vessel. Due to the discontinuous surface, blood cells tend to accumulate there and slow down the speed of blood. This lack of blood flow causes the clot to harden and form a clot. If it faces high pressure or resistance, it may break away from the initial site and flow with the blood and may settle elsewhere.
Broken bone if not treated or set properly can cause thrombosis due to the same reason that the path of the flow of blood is irregular and can prevent a few blood cells from flowing smoothly. Over a period of time, this leads to a clot.
Sprains and strains too can cause thrombosis. When there is a sprain or strain, the muscles surrounding the blood vessel squeeze them, narrowing the diameter of the blood vessel, causing some blood cells to get stagnated and at the point of constriction. This slowly builds up to form a large-sized clot.
Another common cause of thrombosis is injuries to blood vessels during nosebleed, surgery, inserting of the catheter, etc.
Diagnosis of Thrombosis:
Thrombosis by itself is not a major concern but the location and size of the clot matters. The best way to diagnose this is by talking to the patient in depth, exploring their history and symptoms.
Patients who may be having the tell-tale signs of a heart attack but are not actually prone to it may throw light on the fact that it could be a case of thrombosis. Sudden changes in behaviour are to watch out for. It could be excessive sweating, tiredness, incoherence, blurred vision, etc.
The next diagnosis test involves all the physical parameters such as checking and evaluating blood pressure, pulse rate, respiratory rate, body temperature and oxygen levels in the blood.
Blood cell count is an important test that can reveal any abnormalities such as clots. EKG and ECG may be recommended to assess the heart function. The body is checked for any swelling, blueness or redness and swelling. If there is a specific symptom like those of pulmonary emboli, then the doctor may listen and recognize abnormal sounds if there is abnormal blood flow in the lung region.
Ultrasound is one of the commonest test used for the diagnosis of thrombosis. Specific areas of concern are scanned and evaluated for clots.
– Venography : In this diagnostic process, the doctor injects a contrast coloured dye to the patient’s blood vessel. In a few minutes, the dye spreads all over the body. By using fluoroscopic light, the doctor determines the areas where blood flow is stagnant or slow, indicating the presence of a blood clot.
– D-Dimer: This substance is a product of a broken down blood clot. Since it is present only in cases of a clot, it can be evaluated in the blood test to ascertain if the body has a clot or not. Sometimes, necessary clots form in the body, for example, in a healing wound or after surgery. This test cannot evaluate if the clot is a good one or a harmful one.
– CT scan or Computerized Tomography: this diagnostic test tool is used only when it is highly suspected that there is a thrombotic condition. A contrast dye is introduced into the vein intravenously. This test is efficient to evaluate pulmonary blockages by clots. An important factor to consider here is that the dye material can cause some irritation to the kidneys. It is not to be used on patients who have kidney related issues.
A ventilation-perfusion test is used to determine emboli in the lungs. The air intake of the patient is measured and evaluated. Also, the gaseous exchange between the blood flow and the blood flow rates are matched. If there is a mismatch between the two, it is highly possible that there is a pulmonary embolus.
If a clot is found in the vital organs such as the brain, heart, lungs, kidneys, etc., an immediate surgery is ordered. This is due to the fact that many times, the complexities cannot be reversed. Strokes and heart attacks are a common threat that can be expected if the thrombotic condition is not treated on time.
Sometimes a simple x-ray can show signs of swelling in a specific region and this can signify the presence of a blood clot.
Treatment:
Thrombosis can be treated after evaluating the cause, region of the clot and the size of the clot. The treatment is specific to each patient. Considering the patient’s health history and the present health conditions, the treatment is recommended by the doctor.
Blood thinners are the most common agents that are given for treatment. Heparin is also one of the most commonly recommended. It is injected below a few layers of the skin to anticoagulated the blood of the patient. It generally takes a few days to stabilize in terms of viscosity of blood.
In complex or long-term cases where the blood clot is adamant, the same procedure used for the angiogram is used here. I stent is used to clear the clump of clotted blood cells.
Prevention of Thrombosis:
Prevention is better than cure, which is why doctors take rigorous and religious action to prevent blood clots, after surgery or even if the patient has a history.
Anticoagulants also knew as blood thinners are used according to the age, sex, health and physical build of a person.
Compression stockings also help in preventing clots by compressing and relaxing muscles and blood vessels. They are a safe yet reasonably priced way to help the movement of blood in blood vessels.
Keeping legs 4 to 6 inches elevated during sleep is very helpful in preventing the formation of clots. The more the circulation of blood, the lesser the chance of formation of blood clots.
Keeping oneself physically active is the best way to prevent any kind of health issues, including the formation of clots and clumps.
Complications:
Pulmonary embolism is one of the most dangerous life-threatening conditions. It can also elevate to pulmonary hypertension where the blood pressure in the lung region is unnaturally high. This may further lead to more serious complications. In very rare cases, emboli get formed frequently and develop with the passage of time. This could lead to a condition known as Chronic thromboembolic Pulmonary hypertension.
Myths:
There are certain myths surrounding thrombosis. Here is a scientific explanation:
Myth #1: Thrombosis is fatal:
No, thrombosis is not fatal until it is treated on time and especially in the initial stages. It can prove to be fatal only if left untreated for a very long period of time.
Myth #2: Travelling by aeroplane can cause blot clots or thrombosis:
It is not about travelling in an aeroplane, it is about sitting for long hours at a stretch. That could cause restricted blood flow due to limited or no movement of the limbs, especially the legs.
Myth #3: Bed rest is recommended for thrombotic patients:
On the contrary, exercise helps in the best way possible to reduce the risks and even cure the existing thrombotic condition. More the activity and movement of the body, the lesser the chance for the formation of blood clots or clumps.
Myth #4: Thrombosis affects only the elderly:
False. Thrombosis can strike at anyone but the risk factor among the elderly is more because the circulatory system automatically slows down with progressive age. It can happen to anyone irrespective of the age and gender.
