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All you need to know about Blood Clots!

Last updated date: 28-Apr-2022

CloudHospital

15 mins read

Blood, one of the vital bodily fluids, is continuously flowing through our arteries and veins; besides this tremendous job of keeping a constant level of blood in circulation, it is also responsible for transporting oxygen and nutrients throughout the body, as well as it represents the way in which waste is removed, with the help of kidneys. Another important role the blood plays in our complex organism is thermoregulation, this process implies that through blood, heat is distributed and absorbed throughout the body as needed, maintaining a normal and constant core temperature. When the continuous flow of blood is disturbed, because the consistency of the blood thickens, blood clots form.

 

What is a blood clot?

A blood clot, also known as a thrombus, represents a mass of fibrin and blood cells, that is formed as a result of hemostasis, commonly known as coagulation. When blood clots, it does so to stop the bleeding and repair the damage, all in order to keep us from bleeding out whenever we injure ourselves. The blood clots’ process of appearance is a very complex one, as it is performed in steps and requires the good functioning of numerous components like the vessels’ musculature, blood cells, and many coagulation factors.

The first step of hemostasis is vasoconstriction, which slows the blood flow, then the platelets cover and repair the tissue damage, and in the final step, the platelets are replaced with fibrinous tissue. The result of this complicated process is the blood clot, and usually, there is another step that includes dissolving the blood clot and eliminating the waste through the bloodstream.

 

What is a blood clot made of?

Thrombi are made out of two major components: aggregated thrombocytes (platelets) and erythrocytes (red blood cells), and a mesh of cross-linked fibrin protein. They have a gel-like composition and as mentioned, they serve a very important role in the human body: cessation of bleeding.

So, our bodies’ normal response to injury is forming thrombi, however, many things can disrupt this physiological response, either blood thickens or it thins over the limit, which can cause too many blood clots to form, or none at all, respectively. Unfortunately, when blood clots do not dissolve on their own, or when the body creates blood clots in the absence of bleeding, they can be very dangerous to your health.

 

Where can blood clots appear?

Blood clots can form in one area of the body and obstruct the blood flow locally, or they can travel to another site through the bloodstream. Therefore, blood clots can be found anywhere, from your arms and legs to your abdomen or your brain.

 

How long does it take for a blood clot to form?

Depending on the size and severity of the injury, blood clots can show up immediately, as it takes fibrin about 60 seconds to start replacing the platelets that covered the wound initially, or they can show up in weeks or even months from the initial injury.

 

Types of blood clots

The main blood vessels, arteries and veins, are important when it comes to differentiating blood clots, as these large-caliber vessels partake in transporting the vital oxygen to all our organs and in transporting carbon dioxide from our organs back to our hearts and lungs. Whenever a thrombus forms in one of those arteries or veins, serious medical conditions could be triggered depending on the blood clots’ location and dimensions.

Before categorizing blood clots according to their location, it needs to be mentioned that if the blood clot is stationary the medical term for this condition is thrombosis and if the thrombus breaks loose from the vessels’ walls it’s called an embolism. The latter is considered more serious, because an embolus can both block the normal blood flow in the vessel and travel in different parts of the body, causing more damage.

Based on the blood clots’ location of appearance, the following table shows the types of thrombi and their implications:

Type

Symptoms present at the affected area

Onset of symptoms

Cause of symptoms

Complications

Arterial thrombus

(Arterial embolism)

cold feeling

no pulse

lack of movement

paralysis

pain

weakness

discoloration of the skin

Almost immediate

The blockage of the artery leads to oxygen deprivation in the organs it’s supplying

intense pain 

stroke

heart attack 

paralysis

Venous blood clot

(Venous thrombosis)

swelling 

pain

tenderness

increased warmth

cramps

aching

red skin

Late onset (it takes longer for the blood clot in veins to form)

The blockage of the vein in question leads to swelling of the area, as the venous return is disturbed

deep vein thrombosis

Blood clot risk factors

If you suffer from certain diseases, you may be at a higher risk of developing blood clots than the general population, also if the condition is popular within your family, the risk increases, as well. These diseases include obesity and atherosclerosis, cancer, diabetes, a blood clotting disorder, heart failure, cardiac arrhythmias, long-term lung conditions, vasculitis or diseases of the blood vessel. 

Besides diseases, severe trauma can lead to blood clots, as well, the trauma can be caused by a major surgery (hip replacement surgery) or by a car accident. Pregnancy can also precipitate the formation of blood clots, leading to deep vein thrombosis. Some treatments can also favor the appearance of thrombi like cancer treatments, hormone therapy and birth control pills that contain estrogen (examples: the pill, ring or patch).

The lifestyle of the patient plays another important role because habits like smoking and lack of physical activities can favor blood clots. Fortunately, these habits can be corrected, but unfortunately, age is another key factor, as over the age of 65 clots are physiologically favored to form which can not be changed or adjusted. 

 

Blood clot symptoms

Symptoms of a blood clot differ based on the thrombus’ location. Let’s take a look at general information, signs, and symptoms of a blood clot depending on the affected location:

Blood clots in the brain – symptoms:

  • Another term for blood clots in the brain, more commonly used, is stroke;
  • The blood clot can form directly in the brain, or it can develop in any another area of the body and travel to the brain via the bloodstream;
  • The result of the thrombus is hypoxia, which means that the brain does not get enough oxygen, the patient needs immediate care, as the brain tissue cannot survive without oxygen;
  • The symptoms of a stroke vary accordingly to the area of the brain that is damaged;

What causes blood clots in the brain? That is a very good question and the answer is rather simple, any kind of head injury or trauma can lead to the appearance of a thrombus in the brain; as for a blood clot that is traveling from a different part of the body, the reasons of occurrence have been listed above;

 

How to tell if you have a blood clot in the brain?

If you experience any of the following symptoms, a doctor should be consulted right away: 

  • Paralysis
  • Numbness or weakness in the arms, face, legs, this is especially felt on one side of the body;
  • Slurred speech or trouble speaking;
  • Trouble understanding spoken language;
  • Disorientation, confusion, lack of responsiveness and dizziness;
  • Agitation and other sudden behavior and mood changes;
  • Nausea and vomiting;
  • Trouble walking and/or loss of balance and coordination;
  • Vision problems such as blackened, blurred or double vision;
  • Severe and sudden headaches
  • In worst cases, seizures can also be present;

These symptoms can be transient, which means that they can come and go and be felt at different intensities each time. The remission of symptoms is not a sign that the root problem has been solved, so emergency medical care should always be the priority;

The blood clot in brain survival rate is positive, approximately 80% of cases have good outcomes, especially if the blood clot is caught in an early stage.

 

Blood clot in chest – symptoms

Both the heart and the lungs are targeted by blood clot formation, in the following will be present the symptoms and signs of both conditions:

Blood clot in heart - symptoms

Also known as heart attack or heart infarction, which means that the blood supply to and/or from the heart is blocked partially or completely which leads to serious complications and left untreated can ultimately lead to death. Common symptoms and signs include:

  • Chest pain;
  • Lightheadedness;
  • Pain in the jaw, arm, neck or back;
  • Heartburn;
  • Nausea;
  • Racing heart rhythm

The thrombus can be developed in the heart vessels themselves, the name of this condition being coronary artery thrombosis, or it can travel from every other region of the body;

 The cause of the above-mentioned symptoms is oxygen deprivation in cardiac tissues, this eventually leads to systemic problems;

 A risk factor for the occurrence of this specific type of blood clot is atherosclerosis, as this disease causes fatty tissue to be disposed on the walls of arteries.

 

Blood clot in the lungs – symptoms

Usually, the thrombus that can be observed into the lung, is a traveling type of blood clot, medically called pulmonary embolism;

The site from which the thrombus travels is often the leg, especially when the patient is diagnosticated with deep vein thrombosis (DVT), so it can be stated that pulmonary embolism appears secondary to DVT;

Symptoms of lung blood clot:

  • Chest pain;
  • Palpitations or a rapid heart rate;
  • Sudden shortness of breath with no obvious cause;
  • Breathing problems (dyspnea);
  • Coughing up blood (hemoptysis);

All these symptoms of the blood clot in the lungs, are life-threatening and must be evaluated as such, always go to the doctor, if you experience any of the signs and symptoms mentioned above;

Blood clot in lungs – recovery time depends on a couple of aspects such as the stage of the blood clot when it’s being diagnosed, the course of treatment, the compliance and risk factors of the patient.  So, whenever the question “how long does it take to dissolve a blood clot in the lungs?” is being asked, it is safe to say several weeks to a couple of months, to prepare the patient for what is expected of them during the recovery, in order for the treatment to work properly.

 

Blood clot in abdomen – symptoms

There are some organs in the abdomen that favor the occurrence of blood clotting like the stomach or the liver:

The clinical features of a blood clot in the stomach are as follows: 

  • Severe abdominal pain, that can have periods of improvement and periods of exacerbation;
  • Abdominal fluid accumulation (ascites);
  • Nausea;
  • Vomiting;
  • Bloating;
  • Bloody stools or diarrhea;

 

A blood clot in the liver can induce the following symptoms:

  • Nausea and vomiting;
  • Vomiting blood (hematemesis);
  • Abdominal pain (especially in the upper right part of the abdomen);
  • Swelling of the lower limbs;
  • Enlarged spleen (splenomegaly);
  • Unexplained weight loss;
  • Yellow skin and yellow eyes (jaundice).

Some patients can feel intense symptoms and can have complicated clinical features, and some patients can feel no symptoms at all;

DVT is usually the condition that leads to abdominal blood clots, but this type of thrombi is pretty rare, but can have serious repercussions, while HVT (hepatic vein thrombosis) is the condition that leads to liver thrombi, as this medical issue blocks the drainage system of the liver and prevents the natural flow of blood and apport of oxygen. If left untreated, it can ultimately lead to liver failure; this condition is also known as The Budd-Chiari Syndrome;

 

Besides these organs, other abdominal viscerae can be elected for the development of thrombi like the colon or the urinary tract:

Blood clots in the colon: A common sign of this condition is blood clots in the stool.  It usually means that somewhere in the colon there is a bleeding present, the hemorrhage can be caused by a variety of medical issues like: diverticulitis, inflammatory bowel disease, anal fissures, gastritis, polyposis and some types of colon cancer; 

Blood in the stool is enough of a concern to go and see a doctor, but if you also experience dizziness or fainting, hematemesis, severe abdominal pain and high fever, you must go to an emergency care unit right away.

 

Blood clots in the urinary tract: The urinary tract is composed of: the urethra, the bladder, and the kidneys and the thrombus can occur in any of these components. Blood clot in the urine or hematuria is the condition in which the red blood cells can be found in an excessive amount in urine (RBC can be physiologically found in the urine, around one million of them, anything past this number is considered hematuria). Various medical diseases can lead to bloody urine such as: urinary tract infection (UTI), kidney infection (pyelonephritis), a stone in the kidneys (nephrolithiasis) or a stone in the bladder (bladder calculi) and some types of cancers. 

Excess of blood in the urine is as bad as blood in the stool, so medical care should be taken right away, especially if you suffer some of the following symptoms: pain while urinating, fever, loss of appetite, weakness, unexplained weight loss or abdominal pain. It should be mentioned, that bloody urine in a male can be also caused by a prostate issue, like an enlarged prostate gland (benign prostatic hyperplasia). When it comes to women, blood clots passage in urine is normal and expected while menstruating. Blood clots on periods shouldn’t be a concern, but if the bleeding is more abundant the usual, a doctor should be seen for further evaluation.

 

Blood clot in arms: A blood clot can appear in any part of the upper limbs and from there it can travel anywhere through the bloodstream. Based on the region of the upper limb where the thrombus forms, there are: blood clot in fingers, blood clot in the wrist, in the hand and blood clots in shoulders. Symptoms and signs of a blood clot in arms, include the following

  • Swelling, which usually occurs in one arm;
  • Tenderness and cramping-like pain;
  • Reddish or bluish tones of the skin in the affected are;
  • Warm to the touch.

Whenever these symptoms are being felt, medical attention should be sought immediately, as there can be an underlying issue like DVT which can cause a lot of complications that can be life-threatening.

 

Blood clots in legs: Just like with the thrombi in the arms, blood can start clotting in the legs from DVT, the legs are even more predisposed to this than the arms. Examples of thrombi in the legs include blood clot in toes,  blood clot in foot, blood clot in ankle, blood clot in knee,    blood clot behind the knee, blood clot in calves, blood clot in thighs. Blood clot leg symptoms are listed below:

  • Pain, leg pain from the blood clots is usually the most predominant symptom;
  • Swelling and warmth of the affected leg;
  • Red or discolored skin on the same leg;

Bare in mind that sometimes DVT can be asymptomatic.  DVT is a serious medical condition that needs medical attention as it can develop into a pulmonary embolism.

 

How are blood clots diagnosed and evaluated?

After a thorough medical history exam and a physical evaluation, which mostly consists in asking the patient for relevant information and feeling the affected area, the MD should ask for medical imaging to further assess the injuries. If a venous thrombosis is suspected the “gold-standard” imaging is a venous ultrasound, if the results are inconclusive, a Doppler ultrasound or venography can be performed. If you are suspected of an arterial thrombus, the imaging that should be performed is a CT angiography (especially for pulmonary embolism), considering the affected area of the body, the angiographic CT can be performed to the abdomen and pelvis or to the head and neck, also cerebral angiography should always be considered if a stroke is suspected and if the diagnosis of a blood clot in the heart is presumed, a carotid ultrasound should be done.

 

Treatment for blood clots

Medication therapy includes anticoagulants and thrombolytics, which are described in the following sections

Anticoagulants

  • Are commonly known as blood thinners:
  • The most used is unfractionated heparin, usually administrated intravenously or via subcutaneous injection;
  • Another common blood thinner used is warfarin, administrated orally;
  • The newest type of anticoagulatory medication are the direct oral anticoagulants (DOACs), examples: Eliquis and Pradaxa;

Thrombolytics

  • as the name states, they help dissolve the blood clots, though these are recommended only for very large thrombi, that do not respond to anticoagulants.

 

Surgical interventions might also be required in some cases, as follows:

  • Thrombectomy is recommended for large blood clots that cause important damage to the tissues nearby, it consists in the surgical removal of the blood clot;
  • Vena Cava filters - The Vena Cava, a very large vein, transports blood from the lower part of the body back up to the heart and lungs. The surgeon inserts the filter into the Vena Cava to prevent blood from clotting and passing through the vein, all in order to prevent a pulmonary embolism from happening. This procedure is only used for patients with DVT and a very high risk of developing pulmonary embolism later on.

 

Home remedies for blood clots

Besides the medication for blood clots and the surgical procedures, there are a few other things a patient should be informed of, when trying to recuperate from a thrombus or help prevent blood clot occurrence, such as:

  • Taking regular walks;
  • Elevating the affected leg over the hip;
  • Using compression stockings.

 

Conclusion

Blood clots are the body’s physiological response to injury and they are essential for keeping us from bleeding out every time we hurt ourselves, but sometimes internal causes jeopardize this physiological process and two things can result out of this: either blood starts clotting when there is no bleeding to be stopped or it does not clot when it should do so, in order to stop the hemorrhage.

Blood clots that appear pathologically can be life-threatening and need immediate medical attention, there are many therapies that can be conducted and it always help to catch the condition in the early stages, to keep it from complications along the way. What causes blood clots to form is severe trauma, either by injury or by major surgeries.

 

Your takeaway should be the answer to a couple of questions:

How to tell if you have a blood clot?

By looking at the signs and symptoms, based on the location of the initial injury, as the thrombus has a variety of way in which it can manifest; if you have the smallest doubt about having a blood clot, seek medical care.

 

Can you feel a blood clot?

Yes, usually you can feel its signs and symptoms, but sometimes it can go by unnoticed, to be sure medical imaging must be performed.

 

How to treat blood clot?

There are many therapeutical ways of dealing with thrombi, anticoagulant medications being the most used one, but surgery and sometimes natural blood clot remedies might come in handy.

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