A blood CLOT, a small lump of blood cells: red and white blood cells, clotting factors and platelets, which forms when and where it shouldn’t. It ends up blocking a vein or artery preventing oxygen and nutrients from reaching the organ that receives nourishment from that vessel. And the thrombosis, the phenomenon that affects 600 thousand people a year causing deaths or disabilities in over 400 thousand (Alt data – Association for the fight against thrombosis) and which is the most frequent cause of cardio and cerebro-vascular diseases: myocardial infarction, stroke cerebral, venous thrombosis and pulmonary thromboembolism.
For a few weeks of thrombosis there is a lot of talk about the AstraZeneca vaccine, first suspended because it was suspected of causing thrombotic events, then cleared of the accusation, then subjected again to scrutiny by Ema, the European Union Medicines Agency, which today speaks of a “possible link “and indicates that the statistical incidence of thrombosis in people vaccinated with the Oxford preparation is higher than that of the general population but that cases, however, remain extremely rare. The relationship between risks and benefits “remains positive.” April 21 is the 10th edition of the National Day for the fight against thrombosis and this is the month for the prevention of this disease and therefore the time to get to know it better.
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Who is most at risk of thrombosis
“Our system of coagulation it keeps the blood in balance: that is normally liquid, but capable of coagulating to assume the solid state when it is necessary, that is when it meets the walls of the inflamed, traumatized vessels, attacked by a microorganism, when it comes into contact with the air, to prevent both cutaneous and internal bleeding. The balance of this system depends in part on genetics and in part on other factors linked to the health conditions of the individual and to the lifestyle “, explains Lidia Rota Sell, president of Alt-Association for the fight against thrombosis and cardiovascular diseases, former head of the Humanitas Thrombosis Center in Milan.
“For example – continues Rota Vender – he risks more those who have already had a thrombosis event, those who are familiar, i.e. relatives who have been victims of heart attack, stroke or embolism before the age of sixty-five, therefore at a relatively young age. The Rrisk of thrombosis is higher for pregnant women and up to the 40th day after childbirth, those suffering from an acute inflammatory disease or chronic illnesses with exacerbation, such as rheumatoid arthritis. Those who take drugs that may promote clotting are more at risk, for example chemotherapy and hormones, those who are victims of trauma, accidents or have plaster casts on the limbs. And then there are modifiable risk factors: excess weight, cigarette smoking, a sedentary lifestyle”.
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But the concept is that thrombosis doesn’t act alone, it takes a team of risk factors and a person vulnerable for a thrombosis event to occur. “That’s how it is – confirms the expert – none of the risk elements we have listed alone is enough. For the blood to clot when it shouldn’t, we need many accomplices and a person with a balance of the coagulation system a little more fragile than his “, explains Lidia Rota.
Venous and arterial, the alarm bells are different
The venous thrombosis it is the consequence of an abnormal process of blood clotting that flows in a vein, often localized in the legs, but which can also be found elsewhere. A clot forms inside the vessel which slows down the circulation, up to in some cases preventing it, with a consequent suffering of the organs upstream of the obstruction: liver, retina, limbs, lungs. “The alarm bells of venous thrombosis depend on the affected organ: if it is the retina I have a vision disorder, if it comes to the lungs, and in this case we are talking about pulmonary thromboembolism, the signs are shortness of breath, sharp pain in the chest or back, phlegm with blood, cough. If it is a limb the symptoms are unusual cramps, veins that look like red and painful cords, swelling. Here, if at the same time as these signals I am also overweight or obese, or I take drugs that can promote clotting, I could suspect a thrombosis. Diagnosis is made with Doppler ultrasound and a blood sample. The therapy is based on anticoagulants “.
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Another story is the arterial thrombosis, that is, the one that occurs when a thrombus forms inside an artery, a vessel that starts from the heart and carries oxygenated and nutrient-rich blood to the tissues: the disease that follows an arterial thrombosis is called ischemia and kills cells at the which no longer reaches oxygen, which can be heart (heart attack) or brain (stroke) cells. “The culprits of arterial thrombosis are platelets that build up when the artery walls are inflamed or there is atherosclerotic plaque. Atherosclerosis is the stiffening of the arteries and is a condition characterized by the formation, along the walls of the vessels, of plaques that contain amorphous material, cholesterol, inflammatory cells and blood cells ”says the expert.
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And the signals? In short, what are the alarm bells of venous and arterial thrombosis? “While the signs of the venous thrombosis they are slow and subtle, such as swelling, pain not particularly acute, occlusion of an artery causes very strong pain in the affected area – Rota Vender resumes – It’s the pain of heart attack, stroke. In case of suspicion, the intervention must obviously be sudden. The drugs are antiplatelet “.
In the case of occlusion of an artery the most frequent symptom is therefore pain in the area of the body involved: for example it will be in the chest in a heart attack, in the leg in ischemia of a limb, in the eye if the thrombosis concerns a retinal artery. A brain stroke in most cases, it is manifested by loss of sensation or strength in one half of the body: of one arm, arm and leg on the same side, half of the face, or with partial or total loss of speech.
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Prevention
We talked about smoking and cholesterol, obesity and sedentary lifestyle, diabetes. So the lifestyle in the prevention of the risk of thrombosis is very important “it matters a lot – the expert resumes – especially for arterial thrombosis, which is the one that threatens life the most: a healthy diet, low in fat and calories, normal blood pressure, diabetes and cholesterol control, smoking are factors to keep an eye on ”.
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To prevent venous thrombosis it is good to wear elastic stockings during pregnancy, if you have had thrombosis before, if you have varicose veins. “In some situations, such as the classic one of air travel or in any case of forced protracted immobility, it is good to reactivate the circulation by periodically making movements, even while seated. In particular if you have other elements of risk. You must always remember – reiterates the expert – that thrombosis is the result of a set of factors that act as accomplices and that in one case it can be prevented by intercepting its early symptoms, for this reason – concludes the president of Alt – it is necessary to know it “.
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