Every thrombosis is an emergency

Thrombosis often develops silently. However, if it occurs Embolism, the acute consequences are dramatic.

Thrombosis often develops silently. However, if an embolism occurs, the acute consequences are dramatic. The basis for the development of a Thrombosis is a disturbed blood circulation: a local blood clot, a thrombus, forms on the vessel wall. Changes in the vessel walls, blood flow or blood composition can be responsible for this.

External mechanical influences, such as a blow or a fall, or sudden fluctuations in blood pressure with dilation of the blood vessels can cause the entire thrombus or part of it to break off and be carried away with the bloodstream. If the thrombus reaches a section with narrowing vessels, an embolism, a partial or complete blockage, occurs.

“The body’s own substances, but also foreign substances in the blood, can trigger an embolism,” says Dr. Reinhold Lunow. The internist is the medical director of the practice clinic Bornheim near Cologne and Bonn. "Such substances include blood clots in the case of a thromboembolism, fat drops in the case of a fat embolism or even air bubbles in the case of a gas embolism, for example in decompression sickness." Thromboses can occur in any blood vessel.

Depending on where they occur, a distinction is made between venous and arterial thrombosis. The leg veins are most often affected, whereby a distinction is made between a superficial form of thrombosis (thrombophlebitis) and deep vein thrombosis (phlebothrombosis). Clots can also appear in organs and block the supplying arteries, for example in the aorta and the heart. This can lead to Stroke or a pulmonary embolism, a blood clot in a coronary artery, a Heart attack trigger.

Symptoms can quickly become life-threatening

A vascular blockage causes blood to build up in front of the blockage. In the case of a leg vein thrombosis, the circumference of the lower leg increases and it turns bluish. In addition to signs of inflammation, a thrombosis can cause severe, pulling pain and a feeling of tension in the affected extremity. In contrast to such clear symptoms, a thrombosis often does not manifest itself at all in its early stages. However, if an embolism occurs, the consequences can quickly become life-threatening. A pulmonary embolism, for example, is accompanied by shortness of breath, bloody sputum, rapid heartbeat, cardiac arrhythmia, breathing-related chest pain, shock and ultimately cardiac arrest.

"Thrombosis is always an emergency that requires countermeasures as quickly as possible," warns Dr. Lunow. "It is also important to note that the older a blood clot is, the lower the chances of the thrombus dissolving completely. For this reason alone, treatment should begin as early as possible."

There are many causes for thrombosis. Usually several factors work together: any immobilization, for example after an operation or when confined to bed, vascular changes such as varicose veins (varicosis) or inflammation of the veins (phlebitis), diseases such as cardiac arrhythmias or valve defects, malignancies, obesity, Diabetes mellitus or severe infections. If the thrombosis occurs "out of the blue", a tumor may be hiding behind it.

Medications such as diuretics or neuroleptics can also promote thrombosis. For women with existing venous insufficiency, hormone preparations for contraception (contraceptives) or for treating menopausal symptoms can increase the risk of thrombosis. Mechanical causes such as sitting for long periods while travelling and correspondingly bent veins are the basis of what is known as "airplane thrombosis". A hereditary predisposition or acquired changes in the clotting factors in the blood, for example due to liver cirrhosis, can also be the cause. A lack of water (dehydration) after severe diarrhea is also a risk factor. Smokers and pregnant women are also particularly at risk.

"In addition to a thorough physical examination, a blood test provides important information about the condition of the coagulation system," says Dr. Lunow. "Even a simple ultrasound scan can easily identify fresh and older thrombi and assess the risk of an embolism." If a thrombosis is present, the thrombosis process must be stopped in order to prevent a pulmonary embolism and to restore the blocked blood flow. Depending on their condition and the time of treatment, thrombi can be treated in two ways: with medication (thrombolysis) or through surgery (thrombectomy). The latter, however, is only possible up to two days after the vein has been closed.

A health check and a screening can detect thrombosis

If treatment is started in good time, this usually ensures that the thrombosis heals without any consequences. However, if the thrombosis is only recognized late, the risk of chronic damage increases: varicose veins, damaged venous valves (post-thrombotic syndrome) and a pulmonary embolism are possible. In addition, every patient who has already had a thrombosis is particularly susceptible to another blood clot (recurrence). Particularly if several risk factors are present, consistent thrombosis treatment is necessary.prevention operate.

The earlier a thrombosis is detected, the better the chances of recovery. "A conscious lifestyle is particularly important for prevention. Every form of exercise - whether swimming, hiking, cycling - activates the veins and muscle pump. Therefore, you should always make sure to relieve the pressure on the veins and also drink enough fluids," recommends Dr. Lunow. "As part of our Check-ups We determine the individual risk of suffering from thrombosis and give precise tips for the right prevention."

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