Thrombosis or the formation of potentially dangerous blood clots in the vascular system, is a condition that is often associated with significant morbidity and adverse organ or limb outcomes depending on which blood vessel develops thrombosis. The burden of the spectrum of diseases associated with thrombosis is high in every part of the globe and can lead to major morbidity and mortality if the same is not addressed in a timely manner. Nearly 1 in 4 people worldwide are dying due to conditions caused by thrombosis.
On the other hand, with appropriate early medical intervention serious complications can be successfully mitigated and lives saved. 13th October is recognised worldwide as World Thrombosis Day, on the birth anniversary of Rudolf Virchow, a German physician whose pioneering work had given us huge insight in understanding the condition of thrombosis. On this occasion, Onlymyhealth editorial team spoke to Dr. Sidharth Viswanathan, Consultant Vascular & Endovascular surgeon, Amrita Hospital, Kochi, about the symptoms, causes and treatment of thrombosis.
Types of thrombosis
Many disease conditions are known that manifest from thrombosis in the veins or arteries. Venous thrombo-embolism (VTE), a spectrum that includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is one of the most frequently encountered thrombotic events with approximately 10 million cases being reported annually world-wide.
Deep vein thrombosis (DVT), or blood clots that occur in the major leg veins, can cause significant swelling of the limb along with pain and can hamper a person's routine life. There is also considerable risk of a life-threatening condition called pulmonary embolism wherein the clot in the leg gets dislodged and travels towards the chest and clogs the arteries of the lungs. Depending on how massive the clot is, it may also result in cardio-respiratory arrest and death of the individual. On the long run, there is also risk of a condition called post-thrombotic syndrome, a type of chronic venous insufficiency that can cause significant permanent morbidity to the patient.
Thrombosis can also affect the arteries that carry blood from the heart towards the organs and limbs. Thrombosis of the arteries of the limbs can lead to acute limb ischemia (ALI) which if not treated in time may lead to permanent damage to the limb and amputation. According to Dr. Sidharth, the main symptoms of thrombosis are:
- Blood clots in veins
- Swelling in one or both legs
- Tightness and throbbing in the leg
VTE predominantly occurs in individuals who may be immobile for a prolonged duration of time. Common risk factors include:
1. Hospitalisation: Hospitalisation or having undergone a surgical procedure is a risk factor of thickening or clots in the blood.
2. Neurological disorders: Patients who have sustained polytrauma, neurological disorders like stroke or paraplegia, or even a long-haul flight travel
2. Cancer: Cancer is also a risk factor that predisposed to increased risk of thrombosis as blood tends to be more viscous.
3. Covid-19: Yet another group of people suffer from an intrinsic abnormality in their blood that makes them highly prone to thrombosis even without any known provocative event. In the current pandemic scenario, COVID-19 infection too has been found to be associated with a higher incidence of thrombosis, as the development of severe vascular inflammation in some individuals can abnormally trigger the clotting system.
Thrombosis of arteries leading to a particular organ can cause damage to the same by compromising its blood supply, a common example being stroke due to sudden cut-off of blood supply to a part of the brain. This is most often caused by conditions of the heart that predispose to clotting like defective heart valves or abnormal heart rhythms (arrythmias) like atrial fibrillation.
Thrombosis diagnosis and treatment
It is possible to diagnose thrombosis early by appropriate radiological tests like doppler-ultrasound or angiographic studies, following which it is vital to expeditiously treat the same to prevent loss of organ or life. Hence, it is prudent to make public aware of these potentially lethal conditions so that they avoid delay obtaining treatment.
It is equally important to be aware of the potential risk factors and try to avoid the same or use specific preventive strategies. Once a thrombosis occurs and is diagnosed rapidly enough, effective medical therapies in the form of blood-thinning medications (anticoagulants) and if indicated surgical or catheter-based procedures can help reduce the morbidity to the affected organ or limb.
Thrombosis does not discriminate. Clots can affect anyone regardless of location, age, ethnicity or race. By opening our eyes to thrombosis, together we can keep the fight strong against this lesser-known adversary and help abate this dreaded disease among us.
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