Thrombosis: A disease of the old? It threatens the young too + Causes and manifestations

Thrombosis, the formation of blood clots, not only threatens the elderly, but also young people.

Why does it occur?
What does it look and feel like?
What helps with thrombosis?
How to dissolve blood clots (thrombi)?

Because of its high prevalence in the population, identification of people at risk and prevention is extremely important. Despite all measures, mortality from thromboembolism is high. Why?

Thrombosis, thromboembolism and embolism are the most common causes of so-called sudden death in patients of different ages.

I'm sure you've heard the well-known story of someone who was young, healthy, even an athlete. He had no complaints, nothing wrong with him, and then suddenly, out of the blue, he dropped dead. But it wasn't exactly sudden. The sudden and unexpected death had a cause.

Why did we give this example?

(+ Real stories at the end)

Because this is how the life of a young person whose body has developed a blood clot (thrombus) ends.

This can break off for various reasons and then travel through the bloodstream to a point of vascular constriction where it gets stuck and forms an obstruction.

The organ, previously nourished by this blood vessel, gradually fails or suddenly fails, depending on the size of the clot. With large clots that suddenly "shoot" into a vital organ (brain, heart, lungs), there is usually immediate death or a serious condition with a high risk of death.

Interesting:

In medicine, "time window" means the time span from the onset of symptoms, or the onset of a sudden event, to the death of an organ or system.

There can be several.

For example, in a heart attack, there is a concept of a "golden hour". If treatment is given within one hour, a cure ad integrum (without sequelae) is possible. Within three hours, a cure with sequelae is possible. With each additional hour, the success rate of treatment decreases.

Thrombosis and thromboembolism

Thrombosis is a medical condition in which blood clots form in the blood vessels. There are many reasons for their excessive formation. Most of them are medical conditions, sudden onset, serious injuries, surgeries or poor lifestyle resulting in damage to the blood vessel wall.

Clots clog blood vessels. They prevent blood flow and sufficient oxygenation to specific organs and tissues, causing further health complications. These vary depending on which blood vessel or organ is affected.

Thromboembolism is a condition where a clot obstructing a particular blood vessel breaks off and travels further through the blood vessels. The danger is that the thrombus can embolize (shoot, clog) into any organ in our body.

Definition of basic terms

To better understand what thrombosis is, how it manifests itself and what it causes, it is useful to know the basic terms related to it and their meaning.

1. platelets - blood platelets (they ensure blood clotting during injury)
2. thrombus - a blood clot in a blood vessel (a plug made of platelets)
3. thrombosis - formation of blood clots, its presence in blood vessels
4. thromboembolism - blockage of a blood vessel wall by a blood clot
5. thrombophilic state - a disease state in which thrombi form in blood vessels at an increased rate
6. embolism - blockage of the vessel wall by an embolus
7. embolus - a foreign body in a blood vessel (thrombus, fat droplet, air bubble)
8. obstruction - an obstacle
9. atherosclerotic plaque (atheroma) - an obstruction in the vessel wall caused by the accumulation of fat and white blood cells, narrowing the vessel
10. lumen - vascular lumen, diameter, internal vascular space
11. ischaemia - local, partial insufficiency caused by narrowing or obstruction of a blood vessel
12. infarction - local, complete insufficiency caused by total obstruction of a vessel
13. blood stasis - accumulation of blood and impaired to impossible re-circulation
14. varices (varicose veins) - damaged, dilated, elongated and wavy veins
15. thrombolysis - a treatment method where a substance is injected into the inside of a vein to dissolve blood clots
16. anticoagulation therapy - drugs that reduce blood clotting

What happens to the blocked blood vessel and the organ it nourishes?

Thrombosis can occur in a number of ways. It can be a thrombophilic condition, or it can be due to cancer, in which secondary thrombosis is very common.

Clots also often form in more serious injuries such as fractures of large bones. It is also one of the most common postoperative complications.

A thrombus is formed by the activation of platelets, plasma proteins in contact with a damaged blood vessel. Thrombin is formed, which closes the blood vessel. The mechanism is the same as after injury and scab formation.

It is always dangerous because it can break off, travel throughout the body and settle anywhere. Thus it can damage vital organs and cause serious health consequences up to death.

Once it clogs a damaged blood vessel, it causes an obstruction. This often happens, for example, in atherosclerosis, when a thrombus sits on an atherosclerotic plaque.

The obstructed vessel has a narrowed lumen. This causes a reduced supply of blood and oxygen to an organ that was previously well nourished by the vessel.

The reduced supply of oxygen and nutrients to a particular tissue or organ results in its ischemia (ischemia of the heart, ischemia of the brain, ischemia of the blood vessels of the lower limbs...) or infarction (heart muscle infarction, lung infarction, kidney infarction).

Tip: Life after a heart attack

The difference between partial and complete blockage of a blood vessel:

How does thrombosis manifest itself?

Thrombosis has a wide range of manifestations.

It all depends on in which part of the body the obstruction forms. As far as vital organs are concerned, the first manifestation may be sudden unconsciousness and death.

The above manifestations are overwhelmingly present in the listed medical conditions. However, individual circumstances must be kept in mind and the exact course is never known in advance.

1. manifestations of the occurrence of a clot in the brain

Manifestations:

• intense headache
• dizziness
• nausea
• vomiting
• marked pallor
• sweating
• partial or complete paralysis of the opposite half of the body
• speech impairment
• visual disturbance
• disorientation
• impaired consciousness to unconsciousness

2. manifestations of a clot in the heart

Manifestations:

• pressure and burning pain in the centre of the chest (behind the sternum)
• radiating towards the affected part of the heart (left or right upper limb, neck, back and shoulder blades, stomach - often in diabetics)
• tingling around the mouth, tongue or left hand
• difficulty breathing
• pallor
• in worse cases, blue colouration of the lips and extremities (fingers)
• profuse sweating
• nausea
• vomiting

3. manifestations of a clot in the lungs

Manifestation:

• pain in the part of the chest where the obstruction is
• the pain is usually stabbing and pressing
• associated with difficulty in breathing
• blue discolouration of lips, tongue, mucous membranes, extremities (fingers)
• with blue discoloration of the entire face to the upper chest
• palpitations
• tachycardia
• sweating

4. signs of a clot in the kidney

Manifestation:

• dull pain in the retroperitoneal space and sacrum
• on the side of the affected kidney (right or left of the back)
• radiating to the lower back and lower abdomen
• impaired urination
• blood in the urine
• sudden rise in blood pressure
• pallor
• or, conversely, in hypertension, redness in the face
• nausea
• vomiting

5. manifestations of a clot in the liver

Manifestation:

• pain in the liver area (under the right rib arch)
• nausea
• vomiting - as it resembles a gall bladder attack at the outset, it is rarely caught in time
• associated yellow discolouration of the skin and mucous membranes, whites of the eyes
• liver dysfunction to hepatic coma

6. manifestations of a clot in the intestines

Manifestation:

• pain in the umbilicus to the whole abdomen similar to diarrhoea
• admixture of blood in the stool
• impaired defecation
• in more severe cases, intestinal obstruction with development of obstructive shock
• rapid breathing
• rapid heart rate
• low blood pressure
• marked pallor
• excessive sweating
• cold extremities
• general restlessness

7. manifestations of a clot in the eye

Symptoms:

• the first symptoms include sudden onset, unilateral visual disturbance
  • blurred vision
  • blurred vision
  • a dot or spot in the field of vision
  • loss of visual field
• not manifested by pain

8. manifestations of a clot in a limb

Manifested by sudden onset:

• spasmodic pain in the affected limb
• pallor at the start
• later, a blue discolouration of the skin progresses from the fingers upwards
• the limb is cold
• the patient feels a tingling sensation
• or reduced sensitivity

Thrombosis can affect all blood vessels

The blood vessels are spread throughout the human body. They are a kind of closed system of tubes, consisting of arteries, veins and hair cells. Inside them circulate blood cells, oxygen and nutrients, which are transported to all organs and tissues in the body with the constant pumping of the heart.

Arteries carry oxygenated blood to the organs, while veins carry deoxygenated blood to the heart. Despite this difference, clots can form in both types.

Thrombosis affecting the veins

Three main factors are involved in the development of venous thrombosis: primary damage to the vein wall, increased blood clot formation and blood stasis in the area.

Varicose veins are a good example, as they are very common. They mainly affect the calves, where a clear venous pattern can be seen. The veins are not only visible but also palpable, wavy and twisted.

The calves are often swollen, painful and in stasis. It is the most common site of thrombus formation.

Interesting fact: Blood stasis plays a big role in the development of varicose veins. It's increased in people with sedentary jobs. That's why people who work in offices, for example, are more likely to suffer from varicose veins. Waiters who are constantly on the move are less likely.

Thrombosis affecting the arteries

Primary damage to the arterial wall (degenerative changes, inflammatory processes, trauma mechanisms), increased blood clot formation and diseases that increase the risk (heart rhythm disorders, high blood pressure, cancer, etc.) are also involved in the development of arterial thrombosis.

Arterial thrombosis can occur directly in the heart. It can be caused by a combination of diabetes, which damages blood vessels, hypertension and heart failure. They can cause blood stasis and rhythm disturbances that increase the risk of thrombus rupture.

The detached thrombus reaches the coronary vessels (arteries that nourish the heart muscle) and an acute myocardial infarction occurs.

Interesting fact: Myocardial infarction used to be a disease of the elderly. However, its incidence in the young is increasing enormously. The reasons for this are smoking, alcohol, drugs, steroids, contraception, obesity and others.

The most common diseases and consequences of thrombosis

Have you heard of a kidney infarction? Maybe you have and maybe you haven't, because it is not that common. Similar to infarctions of the eye, liver, pancreas, intestines and other less common infarctions due to thrombosis.

Unfortunately, the more common ones are more serious. In many cases, they end in unexpected death.

What is the tricky part of developing a clot in the heart?

The heart is the worst place you'd want to have a clot. It travels from there most often to the coronary vessels and causes a heart attack.

It's also the place where large and multiple clots form, and they embolize very quickly virtually anywhere. They're also called coagulae.

The most important thing in the treatment of acute myocardial infarction is the early management of myocardial infarction. Thrombolysis is a breakthrough treatment for this disease from which many died in the not so distant past.

Cerebral thrombosis is one of the most common causes of disability

Thrombus in the brain is one of the causes of high mortality and the highest permanent disability. It causes cerebral infarction (stroke, apoplexy).

Although the treatment of cerebral infarctions has advanced to a large extent, the size of the thrombus and the time taken to seek medical help play the biggest role.

Delaying thrombolysis of cerebral vessels (treatment - dissolving the clot) results in death, paralysis of half of the body, speech impairment, memory impairment, behavioural disorders. Often the patient is bedridden and dependent on the help of others for the rest of his/her life.

A clot in the lungs causes an unpleasant death by suffocation

The most common thrombosis affecting young people is pulmonary embolism, not least because it is the most common post-operative complication.

Often it occurs in young girls who smoke and take hormonal contraceptives at the same time. Some boys, in turn, because of their dream body, start taking steroids, which promote the development of thrombosis and especially pulmonary embolism.

Whether the thrombus originated in the lungs or was transferred from another site, it clogs the pulmonary vessels, prevents the exchange and delivery of oxygen, and the lungs die and fail. The whole process takes a very short time.

Death occurs by suffocation.

The typical phenomenon shortly after death is a bluish discoloration of the face and upper chest.

Deep vein thrombosis of the extremities often occurs in drug addicts

There is a lot of talk and writing about deep vein thrombosis of the lower limbs. It affects the older age groups due to various chronic diseases they suffer from.

This includes, for example, nephrotic syndrome, venous damage of various kinds, but also dehydration, which is somehow already associated with older age (loss of thirst, febrile state).

The cause of deep limb thrombosis in the young tends to be surgery, bone trauma, burns, septic conditions.

Drug addicts are a risk group. Repeated injection of the drug into the vein causes permanent damage to the vein, weakening of the wall and the development of thrombosis. It is a superficial thrombosis and, based on the harmfulness of the drug and its effect, a deep thrombosis.

Young people and thrombosis. Are you in a risk group?

People at risk of developing thromboembolism are those whose primary disease, injury or lifestyle increases their risk of developing blood clots. Some factors can be influenced and changed.

Children and blood clots

Baby and thrombosis? You find that unbelievable? Then start believing. Even in the little ones, a clot will find its way.

In babies, disease causes such as gene mutations, congenital heart defects, systemic autoimmune diseases, lupus anticoagulans, Kawasaki disease, cancer and others are behind its formation.

Up to 95% of thromboses in children are caused by external factors. These include surgery, trauma, infections, burns and sepsis, insertion of a central venous catheter (need to provide venous access) in the severe condition of a newborn or child.

Tip: First aid for burns in children

Burns to large parts of a child's body (in children, the head is the largest) trigger an inflammatory reaction. They often cause severe secondary infections to severe septic conditions with organ dysfunction. Death can occur due to organ and system failure, burn shock and as a result of thrombosis.

Attention:
In association with children, we are familiar with the term disseminated intravascular coagulopathy. It often results from burns and sepsis, but has other causes. It is a severe condition of internal environmental failure with uncontrolled haemocoagulation activity and increased fibrin formation. Ultimately, a combination of severe bleeding and concomitant thromboembolism occurs.

Causes of thrombosis in young people, for which the modern era and its possibilities

Surgery, trauma and infection cause clots regardless of age. However, other causes are typical for adolescents. More often than not, they are responsible for the consequences themselves.

The reasons are shocking.

Smoking, alcohol, drugs, hormones, contraceptives, steroids, stress, lack of exercise. These are the most common. The consequences of these ailments are partly known to people.

Excessive drinking causes liver failure, smoking causes lung cancer, drugs cause psychological disorders and death by overdose, steroids cause high blood pressure and increased not only muscle mass but also aggression. Obesity and stress increase blood pressure.

Not that there isn't enough, but these addictions and unhealthy lifestyles have one common denominator - thrombosis.

It's only found on the autopsy table

The saddest aspect of some cases of thromboembolism is its onset at a young age and more than once its confirmation only at the autopsy table as the cause of death.

Thrombosis still remains the most common cause of sudden death.

True story:
Frightened father dials 911.
He took his 30-year-old son on a trip.
He woke up in the night to find his child lying next to him in a tent with no signs of life.
He started CPR until the ambulance arrived.
The ambulance doctor resuscitated the man for another 45 min.
Without success.
Autopsy showed a massive myocardial infarction (multiple clots in the heart arteries).

There are many more cases like this. And due to modern lifestyles, they're increasing.

The real story:
A young man went for a jog.
Suddenly he fell and remained motionless.
Eyewitnesses rushed to his aid.
He was not breathing.
They called for help.
But resuscitation could not reverse the disaster.
The autopsy report said: embolization into the a. pulmonalis (blood clot that blocked the largest blood vessel of the lungs).

We offer important information in the articles:

• Thromboembolic disease
• Post-thrombotic syndrome
• Pulmonary embolism
• Deep vein thrombosis
• Superficial venous thrombophlebitis
• Varicose veins
• Chronic venous insufficiency
• Chronic venous disease
• Peripheral arterial disease

Watch out for thrombosis even if you are thinking of going on holiday or relaxing:

• What is travelers' thrombosis: Causes and symptoms? How to avoid it?