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Clinical Care for Thrombosis at the HTC

Thrombosis Focus Areas.jpgHow We Treat Thrombosis
When patients are especially vulnerable to creating blood clots, often due to genetic disorders it is referred to as thrombosis or thrombophilia. As a center dedicated to bleeding and clotting disorders, preventing thrombosis in patients whose families have a history of genetic thrombophilia is a large concern. Even without a diagnosis of thrombophilia, many families are aware of a family history of thrombosis and use the HTC as a resource to prevent clotting problems for themselves and their family members. Others find out about clotting problems due to injury or experiencing a clot and need the expertise, treatment, and follow up care we have available at the HTC.

Our center offers regular clinics for thrombosis patients to manage care and guide them through treatment, medication, provide support, and to prevent future issues. Our pharmacy offers specialized care for our patients’ unique needs and we work in conjunction with our research lab to bring improved treatment to those with clotting problems.

Awareness: Much of our effort at the HTC is to educate patients and their families on their particular condition and help them understand what issues they may face in managing any predisposition to form clots that may cause harm.

Prevention: Many strategies can be used to try and prevent clots from forming. Our center provides the education and medications that may be necessary to keep clotting from interfering with the lives of our patients. Any time those with thrombosis face surgeries or other situations where clotting could occur, our staff is able to provide preventative recommendations to our patients.

Treatment: Once facing clotting problems, often our patients need direct guidance on the treatment of a clot or management in finding the correct treatment for their condition. Our pharmacists are specialized and hold regular clinics to work with our physicians and assist patients directly on managing their care.

Support: Our teams at the HTC provide the expertise to work with patients managing their condition and understand what is required to successfully navigate the specific needs of thrombosis patients. Our research laboratory is continually working to improve the lives of our patients with new methods of testing and treatment.

See our Clinic page for details on how to set up an appointment for care.

Frequently Asked Questions About Thrombosis 

What is Thrombosis?

Thrombosis, also called hypercoagulability, is a disorder that puts patients at an increased risk for excessive blood clotting in the veins and arteries. Proteins in the blood work with tiny particles called platelets to form blood clots, also known as coagulation. Coagulation is a natural, life-saving mechanism that prevents or slows blood loss after an injury. Blood traveling freely through the veins should not clot, but when it does it is called “thrombosis.” When thrombosis occurs, a clot can either partially or completely block the flow of blood in the vessel, even though there has not been an injury to the vein. This tendency to clot too much is called hypercoagulability.

What causes thrombosis?

There are several reasons why a patient may develop blood clots.
  • Damage to a vein can cause thrombosis and can be triggered by physical, biological or chemical factors. Surgery, physical injury, inflammation and immune responses are all factors that can cause clotting to occur.
  • Clotting can be caused by slow or sluggish blood flow. This can be due to extended bed rest or long distance travel where a person doesn’t move around for a long period of time.
  • Some patients’ blood is thicker than normal and is more prone to clotting. There are inherited conditions, such as factor V Leiden, which can increase the likelihood of a blood clot.
  • Some medications, such as birth control pills or hormone therapy, can also increase the risk of clotting in some people. 

What are the signs and symptoms of thrombosis?

Leg: The most common place for a blood clot is in the leg. The symptoms of a clot in the leg are swelling, pain, warmth or redness in the calf or behind the knee, or higher up in the leg or groin.
Heart or Lungs: Clotting in the arteries of the heart or lungs can cause shortness of breath, painful breathing, or chest pain. Symptoms can also include upper body discomfort in the jaw, back, neck or arms.
Brain: Clots in the veins or arteries of the brain often cause severe headache, sudden one-sided weakness, blurred vision, or difficulty speaking.
Sometimes clots may cause no symptoms, especially in other areas of the body.

Why is thrombosis dangerous?

When abnormal clotting occurs inside the blood vessel of a person with thrombosis, it can slow or stop blood flowing from veins, or to arteries, in the arms, legs and other areas of the body that normally have blood flow. A clot inside a blood vessel is called a "thrombus,” and sometimes the thrombus can break loose and travel through the bloodstream, lodging itself in a vessel in the lungs. This kind of clot is called a "pulmonary embolus", and can result in difficulty breathing and strain on the heart, which can be life-threatening. Blood clots can cause at-risk women to have miscarriages. Blood clots can also block vessels in the brain and arteries in the heart, causing strokes and heart attacks, respectively.

What are the risk factors for thrombosis?

There are several risk factors that increase the chances of developing a dangerous clot. Usually, a person must have several risks factors in order to form a clot of this nature.
Risk of deep-vein thrombosis (DVT) increases when:
  • Faced with a significant injury (a broken bone, severe muscle injury or have had surgery) or state of sustained inflammation (severe infection, lupus).
  • The blood flow is slowed due to a prolonged state of decreased activity or mobility, such as a long car, bus, train or airplane ride, significant leg or arm injury or bed rest.
  • There is an inherited or acquired thrombosis risk factor, like Factor V Leiden or Protein C deficiency.
  • There is a previous history of a blood clot.
  • A family member has had a clot in the past.

Is there a cure for thrombosis?

While blood clots can be dissolved and there are means to manage and prevent further clotting, there is not a cure. Recovery will depend upon varying factors including the type of blood clot and its location, how much damage was done by the clot, as well as the speed and type of care that is received upon diagnosing a blood clot. Many people who have experienced blood clots live very normal lives and simply manage their care through medication.

How is thrombosis treated?

There are medicines that can thin the blood and make it less likely to form a clot. Some people with thrombosis only need to take blood-thinning medications when they have an increased risk such as surgery, trauma, pregnancy or long plane/car trip. Other people with thrombosis need to take preventative medicine at all times.
The two most common blood-thinning medications used in recent years are called heparin and warfarin. Usually, doctors will prescribe heparin first, because it works to thin the blood right away. Heparin is frequently administered through an IV in hospitals, but patients may go home on heparin that is injected under the skin. After being on heparin for a while, a doctor might suggest that a patient start taking warfarin. Warfarin is taken by mouth and takes longer to begin working. Patients will continue taking heparin until the warfarin starts working in the blood. Antibiotics, infections, and changes in diet can alter warfarin's effectiveness.
As blood thinners, these medications can cause a patient to bleed more easily than normal. Patients may notice that cuts take longer to stop bleeding and that they may bruise more easily. Special precautions should be taken against head injury, such as avoiding contact sports, using a helmet while riding a bike, always using seatbelts in motor vehicles etc. If a patient on blood thinners has any unusual bleeding, they should their doctor right away.

What can be done to help avoid a clot?

Though these methods cannot guarantee a clot will never form, the following methods can be effective in helping avoid clots:
  • Consult a physician if there is a personal or family history of blood clots.
  • Avoid standing or sitting in the same position for long periods of time.
  • Avoid estrogen-containing birth control or hormone replacement therapy if there is a personal or family history of clots, and consult a physician.
  • Exercise regularly (walking, jogging, swimming, etc.) and maintain a healthy, normal weight.
  • Avoid smoking.
  • Avoid excessive alcohol use.
  • Stay well-hydrated.
  • Check cholesterol levels regularly.
  • Consult a physician to manage any infections when taking warfarin.
Always consult a physician right away if any symptom of a clot appears or if there are any questions about the likelihood of a clot forming.