What Causes Blood Clots?

Blood Clots

Blood clots are necessary for the healing of cuts and wounds but can present serious health problems when they get stuck in the circulatory system. A blot clot (also called a thrombus) involves the coagulation of blood through the group formation of tiny blood cells known as platelets.

Blood clots not functioning properly represent the improper triggering of the coagulation mechanism in undamaged (or only slightly damaged) blood vessels. Blood clots generally fall into two major categories: superficial phlebitis and deep vein thrombosis (DVT).

Superficial phlebitis entails the formation of blood clots in the small veins proximal to the surface of the skin. Symptoms include swelling, skin discoloration, and localized pain. This form of blood clotting is normally easily treatable with minimal complications.

Deep vein thrombosis, on the other hand, represents a potentially life-threatening blood clot formation occurring in a deep vein (most often in one of the legs). Clots lodged in the leg have the ability to travel up to the right side of the heart where they can then be lodged in a pulmonary artery, subsequently causing pulmonary embolism (the potentially fatal blockage of a pulmonary artery). Symptoms of DVT include pain and swelling in the affected area (often the legs), discoloration of the skin, feeling warm to the touch, and heavy aching. Given that the sooner a blood clot is treated, the better the chances of successful recovery, any appearance of symptoms warrants immediate medical attention.

Blood clots are caused by the presence of thrombogenic substancessuch as tissue factor, the von Willebrand factor, and collagenthat exist in the skin or the walls of blood vessels and work to regulate the direction of blood flow. Blood clots causing bodily harm are often caused by the malfunctioning of these thrombogenic substances. Abnormal blood flow can cause the pooling of blood in vital organ areas of the body. For instance, excessive pooling of blood around the heart can cause both arrhythmia and blood clots to form. Other situations that may cause blood clots may include lack of mobility in bedridden patients, in which reduced blood flow can increase the risks of DVT.

Risk factors associated with blood clotting include previous episodes of DVT or pulmonary embolism, family medical history of blood clots, arrhythmia, pregnancy, and certain medications such as hormone therapy drugs.

Given the intricacies of the body’s blood circulation system, there exists a myriad of causes contributing to improper blood clotting. Pre-existing conditions associated with the formation of blood clots include heart attack or heart failure, peripheral artery disease (PAD), antiphospholipid syndrome, arteriosclerosis, Buerger’s disease, essential thrombocythemia, factor V Leiden, polycythemia vera, and stroke.

Unhealthy lifestyle choices also increase the chances of improper blood clotting. For instance, diets high in cholesterol tend to clog arteries and negatively impact blood flow. Reduced circulation, in turn, increases the chances of thrombogenic substances performing abnormally. Lack of physical activity, such as excessive sitting at work or when traveling, may also contribute to blood clotting via reduced circulation. Increased physical exercise not only improves circulatory functioning but reduces the chances of obesity, which is highly correlative to blood clots. Major surgery has also been known to be a contributing factor.

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How Blood Clots Affect the Body

Blood Clots

Blood clotting is a necessary bodily function that aids in the healing of cuts and wounds. However, blood clots (or the technical term: thrombus) can pose serious health risks when they become present in the circulatory system and block the flow of blood and oxygen to bodily tissues. Ischemia, or lack of oxygen, in cells around the blood clot can cause discoloration and swelling, as well as more-life threatening symptoms depending on the location in the body.

A thrombus is particularly dangerous because it has the potential to travel through the body, potentially causing damage in several areas.

Common locations in which blood clots form include the legs, arms, and lungs. For example, a thrombus forming in the legs near the skin is known as a superficial phlebitis, which often causes discoloration and swelling, and is usually easily treatable. If left untreated, complications may include the hardening of blood vessels, infection, and the development of deep vein thrombosis (DVT).

DVT occurs when a blood clot forms in a deep vein, most commonly in one of the legs, usually causing pain and swelling. Some cases of DVT are asymptomatic.

Postphlebitic syndrome can result from DVT, involving blood flow in the area to become less efficient due to blood vessel damage. The most worrisome complication of DVT, however, is pulmonary embolism (PE).

Deep veins in the leg are directly connected to the right side of the heart. DVT commonly leads to PE because clots in the legs can suddenly become dislodged and travel upwards where they are wedged in a pulmonary artery. PE is potentially fatal in that it restricts blood flow in the lungs and prevents tissues in the rest of the body from being oxygenated. The two main symptoms of PE are shortness of breath and severe chest pain, causing some patients to believe that they are experiencing a heart attack. Other symptoms include dizziness, blurred vision, arrhythmia, persistent cough, or coughing up blood. Anyone showing these signs should immediately seek medical attention.

Cerebral embolism is another dangerous form of blood clotting that occurs when a clot in the heart or the carotid arteries gets dislodged and travels up to the brain where it can result in an ischemic stroke. Restriction of blood flow to the brain is quickly and severely damaging, potentially resulting in the death of brain cells within minutes, difficulty speaking, muscle weakness, headaches, or paralysis.

A rare form of stroke resulting from a blood clot, known as cerebral venous sinus thrombosis, is caused by a blockage in the venous sinuses. This form of stroke entails blood being trapped in the brain, cell breakage, and hemorrhage. Symptoms of cerebral sinus thrombosis are similar to an ischemic stroke.

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Symptoms of a Blood Clot

Symptoms of a Blood Clot

There are several ways to treat blood clots, including blood thinner medications (anticoagulants), such as Heparin or Warfarin, which help to prevent further clotting and minimize the chances of existing clots from increasing in size. Anticoagulant medication, however, can be accompanied by several undesirable side effects, as well as the need for regular blood testing.  So what are the symptoms of a blood clot?

Major forms of blood clotting include deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT occurs when a blood clot formation gets lodged in one of the legs’ veins. Often that clot becomes dislodged and travels to the right side of the lungthere it gets wedged in a pulmonary artery and causes pulmonary embolism. The results can be fatal. Risks associated with DVT and PE include old age, lack of mobility, major surgery, injury, and family medical history. The U.S. Surgeon General reports roughly half a million cases of DVT and PE per year, about 20% of which result in death.  

Deep vein thrombosis shows several symptoms. Normally involving a blood clot blocking blood flow in a deep vein in one of the legs, patients often report leg pain, skin discoloration, swelling, and the affected area being warm to the touch. Since these symptoms are concurrent with less severe conditions, such as a pulled muscle, it is important to consult with a doctor as soon as possible to determine the underlying cause of these symptoms.

Pulmonary embolism usually occurs when a clot from deep vein thrombosis breaks free and travels upwards to the lung where it gets wedged in a pulmonary artery. This potentially fatal condition is accompanied by several symptoms, most notably, shortness of breath and chest paincausing many patients to feel as if they are having a heart attack. Other symptoms include skin discoloration, arrhythmia, persistent coughing, anxiety, arm or shoulder pain, blurred vision, numbness or tingling, and fainting. A patient showing these symptoms should immediately seek emergency medical care.

The body cannot tolerate a blood clot blocking blood flow for an extended period of time, as it prevents bodily tissues from being oxygenated. DVT clots are either treated, or they become dislodged and pulmonary embolism occurs. Patients can make a full recovery, sometimes requiring lengthy post-procedure recuperative hospital stays. Others not so fortunate suffer from a potentially fatal stroke or heart attack.

A patient whose suffered a DVT or PE is normally put on anticoagulant medication to prevent recurrent blood clotting and to reduce the chances of current clots from growing in size. The chances of another clot forming after their highest in the weeks following a patient’s first episode of DVT or PE.

Anticoagulant medication, such as Heparin or Warfarin, is accompanied by several side effects, such as headaches, rash, bleeding, cold or flu symptoms, and stomach irritability. Decreased bone strength can occur after taking the medication for long periods of time. Heparin-Induced Thrombocytopenia (HIT) is a rare and serious side effect that usually involves further DVT and PE, possibly resulting in death.

Patients should always consult with their doctor to determine which medications are most appropriate to their current health condition.

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Preventing Pulmonary Embolism

Pulmonary Embolism

Chances of preventing recurrent pulmonary embolism are made better by taking anticoagulants (also called blood thinners), which help stop the formation of new clots and prevent existing clots from growing.

The risk of forming new clots is at its highest during the month following a patient’s first pulmonary embolism, with that risk typically decreasing over time. After having had an episode, however, a patient is left more susceptible to recurrent episodes for the rests of their lives. Common preventatives include taking anticoagulants on a daily and indefinite basis, for both those who have experienced pulmonary embolism and those deemed at-risk by their doctor. Those undergoing surgery in areas with major arteries, such as the legs, hips, stomach, or brain, as well as bedridden patients, are often prescribed blood thinners.

In addition to medication, patients are encouraged to engage in physical activity (within the parameters of their health condition) soon after surgery. Compression stockings are sometimes also recommended to minimize the chances of deep vein thrombosis (DVT), which can cause pulmonary embolism.

Long periods of inactivity, such as traveling by airplane or car, can increase the risk.  Preventative measures include consuming moderate amounts of fluids, stretching, and taking short walks whenever possible. Always consult with a doctor prior to travel if you are at risk for pulmonary embolism or DVT, as they may recommend certain medications to avoid potential episodes.

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Medicating Pulmonary Embolism

Pulmonary Embolism

Patients who repeatedly experience pulmonary embolism may wish to try certain medicines to prevent the formation of new blood clots and arrest size increase in existing clots.

Anticoagulants are commonly prescribed following pulmonary embolism or preceding a likely episode. Anticoagulants are typically taken for three months after an episode in an effort to reduce the recurrence of another blood clot; however, if the risk of recurrence remains high, they may be prescribed indefinitely.

Depending on a patient’s medical history and the severity, a wide variety of anticoagulants are prescribed. Hospitalization following a clot typically involves anticoagulants being administered through an IV drip or as a shot. Patients taking anticoagulants in the long-term often do so with pill medications.

The most common kinds of anticoagulants are Apixaban, Dabigatran, Edoxaban, Heparin, Rivaroxaban, and Warfarin.

Thrombolytic drugs, a more uncommon form of pulmonary embolism treatment, work to dissolve a blood clot directly. However, since they greatly increase the chance of serious bleeding and other complications, they are normally reserved for particularly life-threatening circumstances.

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Surgery for a Pulmonary Embolism

Pulmonary Embolism

Depending on the severity of a particular pulmonary embolism, surgery may be required. The removal of a blood flow-restricting clot is called an embolectomy, which may occur during surgery. The removal of a clot may also be performed through a minimally-invasive procedure called catheter-directed thrombolysis, in which a thin tube is guided through a vein to the blocked area and a thrombolytic drug is applied to dissolve the clot. Embolectomies are rare, and used primarily for urgent cases in which a patient cannot wait for the medication to take effect, or when an otherwise stable patient shows signs of drastically reduced blood flow in the pulmonary artery.

Surgery is often considered a last resort as it poses new risks for blood clots in other areas, therefore potentially causing an additional pulmonary embolism.

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Pulmonary Embolism Explained

Pulmonary Embolism

Pulmonary embolism is essentially a blockage of an artery in the lungs. Pulmonary arteries carry deoxygenated blood from the right side of the heart over to the lungs to be reabsorbed into the bloodstream. Critically affecting a vital function for life, pulmonary embolism is a potentially life-threatening condition.

Blockage in a pulmonary artery greatly reduces the ability for oxygen to be transferred into the blood, which is critical to the survival of every bodily tissue. Although potentially fatal, immediate medical attention for pulmonary embolism greatly increases a patient’s chances of full recovery.

Pulmonary embolism results specifically from a blood clot traveling into the pulmonary circulation from the right side of the heart, at which point (depending on its size) it gets lodged in a pulmonary arteryeither partly or completely blocking blood flow in that area.

Patients previously diagnosed with deep vein thrombosis (DVT)which entails a blood clot formation in the leg—are at a higher risk of pulmonary embolism because leg veins are directly linked with the right side of the heart. In this way, pulmonary embolism can occur subsequent to an abrupt dislodging of a leg clot.

Symptoms include chest pain and shortness of breath. Because of these symptoms, oftentimes those experiencing pulmonary embolism may seek medical attention because they believe they are having a heart attack. Coughing up blood, leg swelling, blue-hued and clammy skin, excessive perspiration, dizziness, arrhythmia, and increased pain while performing certain motions or while coughing, are other symptoms arising from the body struggling to get oxygen.

For smaller-sized clots, a thrombolytic drug is often administered, which thins the blood and works to dissolve the blood clot. In larger-sized clots, minor surgery is performed called catheter-directed thrombolysis, which entails the insertion of a catheter into the vein and through to the location of the clot, at which point the clot is broken into smaller pieces. Thrombolytic is then applied directly, and if any clots remain they are directly removed.

The potentially fatal nature means that medical attention should be sought immediately if symptoms are experienced.

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Symptoms of Pulmonary Embolism

Symptoms of Pulmonary Embolism

A potentially fatal medical emergency, pulmonary embolism involves a blockage of oxygen flow from the right side of the heart to the lungs. Caused by a blood clot lodged in a pulmonary artery, pulmonary embolism requires immediate medical attention.  Let’s look at a breakdown of the symptoms of pulmonary embolism.

The results of treating pulmonary embolism vary. If the blood clot is removed quickly, and without damaging too much surrounding tissue, the patient may make a full recovery soon thereafter. Others require lengthy post-procedure hospitalization care, and a small portion of pulmonary embolism patients die as a result of complications. The sooner someone with pulmonary embolism gets medical attention, the better their chances of survival and recovery.

Shortness of breath (or the technical term: dyspnea) is one of the most common symptoms of pulmonary embolism. Typically accompanied by extreme anxiety, a patient experiencing shortness of breath is unable to relax their breathing, feeling as if they are in the midst of intense exercise. This symptom tends to increase in severity, making even minor physical activity extremely tiring or painful.

The second most common symptom is chest pain, sometimes leading those suffering from pulmonary embolism to seek medical attention because they are under the impression that they are having a heart attack. These chest pains are often sharp and specific to one side, with a burning or aching sensation occurring in one or both shoulders. Pain is often exacerbated by deep breathing, which in turn, contributes to a worsened shortness of breath.

Another frequently reported symptom is persistent coughingincluding the coughing up of blood in more severe cases.

Leg swelling and pain often occur, largely due to the high rate of concurrence between pulmonary embolism and deep vein thrombosis (DVT), which involves a blood clot in a leg vein. DVT can lead to pulmonary embolism because the leg veins are directly linked to the right side of the heart. A dislodged clot in the leg can travel up and become wedged in a pulmonary artery.  

Associated symptoms include arrhythmia, excessive perspiration, blue-hued or clammy skin, dizziness, and fainting, which all arise as responses to the body struggling to receive oxygen.  

Experiencing any of the above symptoms warrants immediate medical attention as chances of survival and recovery are drastically improved the earlier pulmonary embolism is treated.

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