How to prevent a blood clot

How to prevent a blood clot

Blood flows constantly through our body. In adults, it is five to six liters that transport nutrients and oxygen to the last cell in the body   , to name just one of the many functions of the blood. However, it is just as vital for the organism that the blood stops flowing at the decisive moment. Otherwise, any injury, no matter how small, would lead to dangerous bleeding. Hemostasis is the process of stopping bleeding.

Hemostasis: The normal process

Hemostasis is divided into two phases:  primary and secondary hemostasis .  Primary hemostasis is the body’s immediate response to injury. Platelets,  a regular component of blood, adhere to the edges of the wound and form a plug-like seal. At the same time, the blood vessel contracts, the blood flow is throttled and less blood escapes as a result.

The time from the first drop of blood to the first closure of the injured area usually lasts two to three minutes and is called the bleeding time. However, the closure by the blood platelets is not yet stable. A permanent, firm closure takes place via secondary haemostasis, and this describes the activation of blood coagulation. A variety of coagulation factors are involved.

Here, like a series of dominoes, with one stone bumping into the next, one coagulation factor activates the next, until finally a whole cascade has elapsed and the defect is reliably sealed with a stable clot pending final repair.

Increased tendency to clot

Many people have a tendency to develop more clots. There are many reasons for this, such as a changed composition of the blood or a change in the flow rate. But changes in the vessel wall play a special role

  • as a result of an injury,
  • as a result of inflammation,
  • or as part of  atherosclerosis .

Fatally, the changes activate hemostasis and clot formation occurs in the blood vessel. This can lead to the affected blood vessel becoming completely blocked, or to the bloodstream carrying the clot to a distant blood vessel, for example in the brain or lungs, with serious consequences for the organism.

Blood clot medicines

In order to prevent this, various medications are used if there is a tendency to blood clots. One is the platelet aggregation inhibitors (TAH), which are drugs that prevent the blood platelets from  aggregating to  form a clot. Then there are the anticoagulants, which are substances that interrupt the coagulation cascade.

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The best-known drug from this group is  acetylsalicylic acid , or ASA for short. It prevents the formation of clots in the arteries in atherosclerosis and is   usually prescribed long-term after a heart attack  or  stroke . However, ASA does not prevent clots in the veins, which is why it is not suitable, for example, for preventing so-called “economy-class syndrome”, i.e. venous thrombosis, for example on long-haul flights.

ASA can lead to gastric mucosal inflammation and even  stomach ulcers  and stomach bleeding, so patients should see their doctor if they experience symptoms such as acid  reflux  or a generalized feeling of discomfort in the stomach area. People with  asthma  can have an allergic reaction to ASA, so caution is advised when taking it. The drug may not be taken by anyone who has had a stomach ulcer, and it is also prohibited in the last trimester of pregnancy.

Caution is advised if additional pain medication is required, as these can weaken the effect of ASA. However, when taken at the same time as anticoagulants, ASA can cause severe bleeding. And anyone who gets ASA should draw the doctor’s attention to this before a planned surgical procedure, because there is an increased risk of bleeding when taking ASA. Therefore, if it is safe to do so, ASA should be stopped one week before the procedure. Because that’s how long it takes for the effect to wear off. Other substances in this group have so far mainly been used as reserve drugs, i.e. only if a patient cannot tolerate ASA.

Anticoagulants against blood clots

Of the drugs that interrupt the coagulation cascade, the coumarins are relevant outside of the hospital. They reduce the risk of clot formation in the entire bloodstream, i.e. both in the arteries and in the veins. They are used, for example, in patients who have had a leg vein thrombosis, a  pulmonary embolism  or a heart attack. side effect  can be an intolerance, but also  hair loss  or  liver inflammation . For this reason, people with liver disease, for example, should not be given coumarins.

Anyone who  takes coumarins  needs continuous medical attention. Because if the coagulation is reduced too much, dangerous bleeding can occur. On the other hand, if it is reduced too little, the effect may not be sufficient and a clot may form. Therefore, the so-called therapeutic range is regularly checked by taking a blood sample and then the daily tablet intake is determined. Patients who have to take the drug long-term can learn in a training course how to determine their coagulation value and then adjust the tablet intake independently.

In everyday life, coumarin patients have to bear in mind that they bleed longer than other people when they are injured. However, the blood does not clot completely, and with small wounds it is usually sufficient to press on the wound for a few minutes with a clean gauze compress or other suitable dressing material. For larger wounds, however, a doctor should be consulted, who may administer a drug that quickly increases clotting. Caution is also needed if bleeding occurs for no apparent reason, such as a  nosebleed  or blood in the stool.

Coumarins and Nutrition

Incidentally, vitamin K  increases coagulation when coumarin is taken. However, the effect only sets in slowly, which is why it makes no sense to carry medication with vitamin K as an antidote in an emergency. However, vitamin K is also important because many foods contain large amounts of vitamin K, such as  spinach  and broccoli.

Nevertheless, a coumarin patient does not have to do without these foods, they should only be eaten evenly throughout the week and not in large quantities. There are no other food restrictions either, there is no “coumarin diet”.

Special care should be taken with coumarin patients

When visiting a doctor, it should always be pointed out that coumarins are being taken. Because even an injection into the muscle is not allowed in coumarin patients, and even the extraction of a tooth needs to be well planned. There are also a large number of drugs that strengthen or weaken the effect of coumarins, which is why other drugs should only be taken after consulting a doctor.

Very important:  Anyone who takes coumarins receives an ID card in which, among other things, the coagulation values ​​and the tablet intake are noted. You should always carry this ID card with you!

Knowledge means security

People who take anti-clotting medication often need it throughout their lives. However, this statement should not discourage, but rather give the incentive to want to know as much as possible about the effects and side effects of “their” medication. Because the more you know about it, the safer you will be in dealing with it. And once you get the whole thing under control, there’s actually nothing standing in the way of a fairly “normal” life.

 

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