Blood clot prevention and treatment reduces the risk of stroke, heart attack and pulmonary embolism.
Heparin and warfarin are often used to inhibit the formation and growth of existing thrombi; the former binds to and activates the enzyme inhibitor antithrombin III, while the latter inhibits vitamin K epoxide reductase, an enzyme needed to synthesize mature clotting factors.
Virchow's triad describes the pathogenesis of blood clot formation:
- Endothelial injury (injury to the endothelial cells that line enclosed spaces of the body, such as the inside of blood vessels) (e.g. trauma, atheroma)
- Abnormal blood flow (loss of laminar flow resulting from stasis in veins or turbulence in arteries) (e.g. valvulitis, aneurysm)
- Hypercoagulability (e.g. leukaemia, Factor V mutation (Leiden))
Disseminated intravascular coagulation (DIC) involves widespread microthrombi formation throughout the majority of the blood vessels.
This is due to excessive consumption of coagulation factors and subsequent activation of fibrinolysis using all of the body's available platelets and clotting factors.
The end result is hemorrhaging and ischaemic necrosis of tissue/organs.
Causes are septicaemia, acute leukaemia, shock, snake bites, fat emboli from broken bones, or other severe traumas. DIC may also be seen in pregnant females.
Treatment involves the use of fresh frozen plasma to restore the level of clotting factors in the blood, platelets and heparin to prevent further thrombi formation.
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