heart-attack.ppt
- 1. • Thrombosis is the formation of a blood clot (thrombus) inside one of our blood vessels or a chamber of our heart. It prevents blood from flowing normally through the circulatory system. • Thrombosis occurs when blood clots block our blood vessels. There are 2 main types of thrombosis: • Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into the heart. • Arterial thrombosis is when the blood clot blocks an artery. Arteries carry oxygen-rich blood away from the heart to the body Thrombosis
- 2. • Blood clotting, also known as coagulation, is the body’s first line of defense against bleeding. • When we hurt ourselves, our clotting system forms a “plug” or “seal” to protect us from losing too much blood. • Our bodies often break down the clot after we’ve healed – but sometimes, clots form inappropriately or fail to dissolve after an injury. A blood clot that forms and stays in a blood vessel is called a thrombus. DGFDHGGFKHKLHL
- 3. • Thrombosis: When a thrombus forms in a blood vessel • Embolus or Embolism: A clot that detaches and travels through blood vessels to another part of the body DGFDHGGFKHKLHL
- 4. • There are two main types of thrombosis: • Arterial thrombosis refers to a blood clot that blocks an artery. Arteries carry blood away from the heart to other parts of the body. Arterial blood clots can block blood flow to the heart and brain, often resulting in a heart attack or stroke. • Venous thrombosis, also known as venous thromboembolism or VTE, refers to a blood clot in a vein. Veins carry blood to the heart from other parts of the body. VTE is a condition that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). DGFDHGGFKHKLHL
- 5. • Venous thrombosismay be caused by: • Disease or injury to the leg veins • Not being able to move around (immobility) for any reason • A broken bone (fracture) • Certain medicines • Obesity • Inherited disorders, or a greater likelihood of having a certain disorder based on your genes • Autoimmune disorders that make it more likely your blood will clot • Medicines that increase your risk of clotting (such as certain birth control medicines) What causes thrombosis?
- 6. • Arterial thrombosismay be caused by a hardening of the arteries, called arteriosclerosis. This happens when fatty or calcium deposits cause artery walls to thicken. This can lead to a buildup of fatty material (called plaque) in the artery walls. This plaque can suddenly burst (rupture), followed by a blood clot. • Arterial thrombosis can occur in the arteries that supply blood to the heart muscle (coronary arteries). This can lead to a heart attack. When arterial thrombosis occurs in a blood vessel in the brain, it can lead to a stroke DGFDHGGFKHKLHL
- 7. • Risk factors for venous thrombosis may include: • A family history of a blood clot in a vein deep in the body, called a deep vein thrombosis (DVT) • A history of DVT • Hormone therapy or birth control pills • Pregnancy • Injury to a vein, such as from surgery, a broken bone, or other trauma • Lack of movement, such as after surgery or on a long trip • Inherited blood clotting disorders • A central venous catheter • Older age • Smoking • Being overweight or obese • Some health conditions, such as cancer, heart disease, lung disease, or Crohn's disease DGFDHGGFKHKLHL
- 8. • Risk factors for arterial thrombosis may include: • Smoking • Diabetes • High blood pressure • High cholesterol • Lack of activity and obesity • Poor diet • Family history of arterial thrombosis • Lack of movement, such as after surgery or on a long trip • Older age DGFDHGGFKHKLHL
- 9. • What are the symptoms of thrombosis? • Each person’s symptoms may vary. Symptoms may include: • Pain in one leg (usually the calf or inner thigh) • Swelling in the leg or arm • Chest pain • Numbness or weakness on one side of the body • Sudden change in your mental state • The symptoms of thrombosis may look like other blood disorders or health problems. Always see your healthcare provider for a diagnosis. DGFDHGGFKHKLHL
- 10. • How is thrombosis treated? • Your healthcare provider will create a treatment plan for you based on: • Your age, overall health, and medical history • How sick you are • How well you handle certain medicines, treatments, or therapies • If your condition is expected to get worse • What you would like to do • Treatment may include: • Blood-thinning medicines (anticoagulants) • Thin tubes (catheters) to widen the affected vessels • A wire mesh tube (stent) that holds a blood vessel open and stops it from closing • Medicines to interfere with or dissolve blood clots DGFDHGGFKHKLHL
- 11. • What are the complications of thrombosis? • Thrombosis can block the blood flow in both veins and arteries. Complications depend on where the thrombosis is located. The most serious problems include stroke, heart attack, and serious breathing problems. DGFDHGGFKHKLHL
- 12. • Key points • Thrombosis occurs when blood clots block veins or arteries. • Symptoms include pain and swelling in one leg, chest pain, or numbness on one side of the body. • Complications of thrombosis can be life-threatening, such as a stroke or heart attack. • Treatment includes medicines that thin the blood or prevent clots, and using stents or catheters to open blocked vessels. • Prevention includes being active, quitting smoking, losing weight, and managing other health conditions. DGFDHGGFKHKLHL
- 14. • If there's too much cholesterol in the blood, the cholesterol and other substances may form deposits (plaques) that collect on artery walls. • Plaques can cause an artery to become narrowed or blocked. • If a plaque ruptures, a blood clot can form. Plaques and blood clots can reduce blood flow through an artery. DGFDHGGFKHKLHL
- 15. • In arteries, disruption of atherosclerotic plaque triggers platelet aggregation and activation of coagulation and culminates in the formation of platelet-rich thrombi that obstruct blood flow—a process known as atherothrombosis. This process is the underlying cause of myocardial infarction (MI), ischemic stroke, and acute limb ischemia. Blood flow in veins is slower than that in arteries, so venous thrombi contain fewer platelets and more fibrin than arterial thrombi.1 Thrombosis in veins leads to deep vein thrombosis and pulmonary embolism, which collectively are known as venous thromboembolism (VTE). Arterial and venous thrombosis is responsible for 1 in 4 deaths worldwide causing an estimated 18 million deaths each year.2,3 Therefore, thrombosis is a major healthcare concern. DGFDHGGFKHKLHL
- 16. • therothrombosis starts with atherosclerotic plaque disruption, which exposes tissue factor and subendothelial collagen and VWF (von Willebrand factor). Tissue factor initiates coagulation, which leads to the generation of factor Xa and thrombin. Platelets adhere to exposed collagen and VWF and release TXA2 (thromboxane A2) and ADP, which activate ambient platelets. Thrombin also serves as a potent platelet agonist. Activated platelets aggregate and the platelet aggregates are solidified by fibrin to form a platelet- fibrin thrombus. The direct oral anticoagulants include rivaroxaban, apixaban, and edoxaban, which inhibit factor Xa and dabigatran, which inhibits thrombin. By attenuating thrombin generation or inhibiting thrombin, the direct oral anticoagulants attenuate fibrin formation. Aspirin inhibits TXA2 synthesis by irreversibly acetylating COX-1 (cyclo- oxygenase 1), whereas clopidogrel, prasugrel, and ticagrelor block P2Y12—the major ADP receptor on platelets. Dual pathway inhibition involves the administration of a low dose of rivaroxaban to attenuate thrombin generation together with aspirin to reduce platelet activation. DGFDHGGFKHKLHL
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