What is Thrombus?

It is the final product of blood coagulation and it is also known as a blood clot. Thrombus consists of two components which are, 

Red blood cells and platelets
Cross-linked fibrin proteins

Sometimes these substances are named as cruor.

Thrombus is formed in response to injury to prevent bleeding.

But it can be harmful when it is present in the vessels of the body and causes a condition which is known as thrombosis.

In thrombosis, the clots obstruct the blood flow.

Mural thrombi are the type of thrombin that adheres to the vessel wall.

Mural thrombi are generally found in the Aorta which restricts the blood flow but does not block him entirely.

what are the causes of a Thrombus?

Causes are

1.  Endothelial injury

Injury to endothelial occurs due to trauma, smoking, hypertension, and atheroma.

2. Stasis

Stasis is caused by factors that lead to prolonged immobility and reduced blood flow.

3.  Hypercoagulability

The causes of it are cancer, and factor V mutation.

4.  DIC

Disseminated Intravascular coagulation throughout the majority of the blood vessels in the body also leads to the formation of microthrombi. DIC causes are septicemia, leukemia, shock, snake bite, fat emboli, and severe traumas.

Other causes include

5. Smoking
6. High level of cholesterol
7. Obesity
8. Cancer
9. Diabetes mellitus
10. Stress
11. Lack of exercise 

 

What is the Classification of thrombus?

Thrombi are classified into three major groups on the basis of the number of platelets and red blood cells present in the thrombus.

1.  White thrombi ( platelets dominant)
2.  Red thrombi ( red blood cells dominant)
3.  Mixed thrombi ( intermediate)

 

Pathophysiology

Thrombi are usually formed in response to the injury and become activated in the uninjured vessel.

Their activation in large vessels causes a decrease in blood flow while in small vessels it causes a blockage.

When the thrombus becomes free-floating then it is known as an embolus.

 

what are the risk factors?

The main causes which increase the risks of blood clot formation in the vessels are, 

Atrial fibrillation
Heart valve replacement
Heart attack
Genetical abnormalities.

What is the procedure of the formation of a blood clot?

The formation of a blood clot is done by the activation of platelets and the cause of which is a vessel breach.

Once the platelets become activated they activate more platelets and the process goes on which lastly results in the formation of a thrombus.

Thromboregulation regulates this process.

Prevention

Prevention is necessary because it reduces the risk of stroke, heart attacks, and embolism.

To inhibit their formation and growth heparin and warfarin are used.

Heparin inactivates thrombin and factor Xa. while Warfarin inhibits vitamin k epoxide reductase.

Treatment

Streptokinase is used to dissolve blood clots in the coronary vessels but it is none specific due to which it causes many secondary problems.

Another clot dissolver is tissue plasminogen activator which works faster and is specific. But recent research shows that this drug could have toxic effects in the CNS.

Hementin is also used for cardiac patients which are produced by genetically engineered bacteria.

 

what are the Outcomes?

There are possibly four outcomes of a blood clot which are

  • Propagation
  • Embolization
  • Dissolution
  • Organization
  • Recanalization

Propagation occurs toward the heart.

Embolization occurs when the thrombus becomes mobile.

Dissolution occurs when a thrombus breaks up.

Organization and recanalization involve the ingrowth of fibroblast into rich fibrin thrombus.