Thrombosis

Thrombosis occurs when a blood clot forms inside an artery or a vein. While blood clotting is a natural process that seals wounds to prevent blood loss, thrombosis involves a clot forming without any injury. The clot can grow large enough to block the blood flow within the vessel, or it may travel through the bloodstream and cause a blockage in another area of the body.  

Thrombosis is often triggered by factors that disrupt the normal blood clotting process, known collectively as Virchow's triad. The condition can develop due to slowed blood flow, changes in blood composition, or damage to blood vessel walls. Risk factors include: 

• Smoking 
• Pregnancy 
• Use of the contraceptive pill 
• Damaged blood vessels 
• Surgery under anesthesia 
• Genetic clotting disorders 
• Aging 
• Cancer 
• May-Thurner syndrome 
• Atrial fibrillation 
• Long periods of inactivity (e.g., during flights) 
• Restricted mobility of arms or legs 

The likelihood of developing thrombosis increases with the presence of one or more of these factors. 

There are two primary forms of thrombosis: 

1. Arterial Thrombosis (develops in an artery) 
2. Venous Thrombosis (develops in a vein) 

Arterial Thrombosis occurs when a clot blocks an artery, often affecting the coronary arteries, which supply oxygen-rich blood to the heart muscle. When this blood flow is obstructed, it can cause a heart attack. If a lung artery is blocked, it leads to a pulmonary embolism. Similarly, a clot in the carotid artery that supplies blood to the brain can cause a stroke. 

Venous Thrombosis involves the formation of a clot within a vein. It is categorized into: 

• Superficial Vein Thrombosis (SVT): Occurs near the skin's surface, typically in the legs. It can cause redness, swelling, and tenderness around the vein. 
• Deep Vein Thrombosis (DVT): Forms in the deep veins located in the muscles of the legs. It can be serious if a portion of the clot breaks off and travels to the lungs, resulting in a pulmonary embolism. 

Symptoms vary depending on the location of the clot: 

• Legs or Arms: 
  - Tightness or pain 
  - Swelling 
  - Warmth or heavy sensation 
  - Blotchy skin (red, white, or blue) 
  - Muscle cramps 
  - Shiny skin

• Pulmonary Embolism:
  - Shortness of breath
  - Chest pain or tightness
  - Elevated temperature
  - Coughing (possibly with blood)
  - Palpitations 

The best way to reduce your risk is by adopting a healthy lifestyle and avoiding prolonged periods of inactivity. Recommendations include: 

• Maintaining a balanced diet 
• Avoiding smoking 
• Managing weight 
• Wearing loose clothing 
• Elevating feet when sitting or lying down 
• Drinking plenty of water 
• Regular physical activity 

Daily exercises like toe stretches, walking in place, and leg raises can further lower the risk. 

If thrombosis is suspected, a doctor will first assess symptoms and perform a blood test. If the test detects substances released when a clot forms, imaging tests like ultrasound, duplex scanning, or angioplasty may be required. A lung scan may also be used to rule out pulmonary embolism.  

Thrombosis is typically treated with anticoagulants (blood thinners) to reduce clot growth and allow the body to break down the clot naturally. Treatments include: 

• Heparin: Given by injection, it prevents clot formation. 
• Direct Oral Anticoagulants (DOACs): Delay the action of clotting proteins. 
• Coumarins: Inhibit Vitamin K, necessary for certain clotting proteins. 
• Antiplatelets: Mild blood thinners. 

For DVT, compression stockings may be recommended to reduce swelling and prevent complications. 

Patients undergoing treatment for thrombosis will be closely monitored with regular blood tests to adjust medication if necessary. To prevent recurrence, lifestyle changes are crucial, such as: 

• Attending regular medical check-ups 
• Informing healthcare providers of a history of thrombosis before any procedure 
• Carrying an international medical statement when traveling 
• Staying active and avoiding high-risk sports 
• Eating healthily and paying attention to the body's signals 

Each treatment may have specific side effects, so it's important to refer to medication leaflets for details. If you have concerns, consult with your doctor.  

While thrombosis can affect anyone, certain factors increase risk. These include genetic predisposition and physical conditions that cause blood clots due to prolonged pressure on blood vessels. Regular movement and lifestyle adjustments can greatly reduce the risk.  

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