Blood Clots (cont.)
What are the risk factors for blood clots?
The risk factors for arterial clots are those that are
common to all diseases that cause narrowing of blood vessels. They include:
Venous clots are formed due to one of two main reasons.
- Most commonly, when the body stops moving, the risk of blood clots
increases, since the lack of muscle movement allows blood to become stagnant in veins.
- This
typically may occur when a person is hospitalized or bedridden after illness or
surgery.
- It may also
occur with long trips either in a car or a plane where hours may pass without a
person getting up to walk or stretch.
- Orthopedic injuries and casting also put
the patient at risk.
- Pregnancy is a risk factor for forming blood clots in the
legs and pelvis, since the growing
uterus may
slow blood flow back to the heart to a sufficient extent that blood clots may
form.
- There may be a genetic or inborn error in the clotting mechanism,
making a person hypercoagulable (hyper=more + coagulation= clotting) and at
greater risk for forming clots.
What types of conditions are caused by blood clots?
Blood clots may cause life-threatening medical
conditions, and for that reason are foremost in the mind of health care
practitioners when it comes to diagnosis and prevention.
Deep venous thrombosis and pulmonary embolism
Deep venous thrombosis may lead to a
pulmonary embolism, a condition in which
the clot breaks off in a leg vein, travels in the veins back to the heart, and is pumped out
of the heart through the pulmonary artery to the lungs with blood to be
oxygenated in the lungs. In the lungs, the blood clot becomes lodged in the
small blood vessels of the lung.
An embolus is the medical
term for a blood clot that has moved with the bloodstream to a different
location. With pulmonary
embolus (pulmonary embolism), two issues occur.
- The lungs' blood supply is comprised and the
affected area of lung tissue may infarct,
or die.
- Because of the
blockage, the ability of the lung to provide oxygen to the body is decreased and
hypoxia (decreased levels of oxygen in the blood and throughout the body) may
occur.
Even if venous blood clots do not embolize, they may cause significant local
issues with swelling and pain. Since blood cannot return to the heart if a vein
is blocked by a clot, the limbs may chronically swell and have decreased
function in a condition called chronic thrombophlebitis.
Arterial thrombus
An arterial thrombus stops the blood supply to the tissues beyond the
blockage, depriving cells of oxygen and nutrients. This quickly leads to tissue
death. Arterial thrombus is the mechanism that causes:
Atrial fibrillation
In atrial fibrillation, small clots may form along the walls of the atrium or
the upper chambers of the heart. Should one of these clots break off, if can
embolize, or travel in the bloodstream to the brain, blocking an artery and
causing a stroke. Other arteries may also be involved by this process, including
those that supply the bowel. This can cause mesenteric ischemia
(mesentery=lining of the bowel + ischemia=loss of blood supply) and potential
necrosis (tissue death) of the intestine.
Blood should clot anytime it becomes stagnant. This also means that clots
will form when blood leaks out of blood vessels.
Examples include some of the following:
- With bleeding peptic ulcers, patients may
vomit liquid blood mixed with
clot.
- Patients with rectal bleeding may also have clot mixed with the
bloody stool if there has been time for the clot to form.
- Sometimes patients with urinary tract or bladder infections develop
associated bleeding in their urine, and small clots can form. On occasion these
clots may be so big that they cannot be passed and block the
urethra, preventing
urination and causing urinary retention.
- Vaginal bleeding is a normal event for most women in the reproductive years
and occasionally, blood can pool in the
vagina and form clots before being
expelled. If clots form in the uterus, they may cause significant pain and
pressure as they pass through the cervix while being expelled.
Next: What are the symptoms of blood clots? »
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