A blood clot can surface unexpectedly—following a flight, dehydration, or seemingly without any apparent cause. Oleg Georgievich Gulaev, a cardiovascular surgeon and Candidate of Medical Sciences, explained to “Rambler” how thrombi develop and who ought to exercise heightened vigilance.
What Thrombosis Is
Blood possesses two opposing capabilities: it must maintain constant circulation, yet simultaneously thicken and coagulate when necessary to prevent bleeding. Platelets are responsible for blood clotting. They become active when a vessel wall is damaged. Platelets adhere to each other, forming a plug. In turn, the platelets themselves activate specific proteins, initiating a chain reaction that causes the thrombus to grow and solidify. As healing occurs, the clot gradually dissolves.
“Problems arise when this process turns pathological, leading to thrombosis. Blood properties are influenced by numerous factors and conditions, ranging from dehydration to systemic diseases.”
Thrombi can form not only due to external injuries but also because of other reasons:
Blood circulation slows down due to immobility, such as during long flights or recovery phases after injuries.
Blood coagulation temporarily increases after surgery.
The inner lining of blood vessels is compromised (for instance, due to atherosclerosis or varicose veins), allowing platelets to accumulate in these areas.
A congenital disorder where clotting factors are overactive or the body produces an excess of platelets.
The individual is taking specific medications (e.g., hormonal contraceptives containing estrogen and progestin).
Oncological diseases.
Types of Thrombi
Thrombosis is the formation of a clot that impedes normal blood flow. It can occur in both arteries and veins.
Arterial thrombosis can lead to ischemia (oxygen deprivation) and subsequent necrosis (tissue death) in the areas supplied by that artery:
Coronary artery thrombosis can cause a myocardial infarction (heart attack).
Cerebral artery thrombosis can result in an ischemic stroke.
Limb artery thrombosis can lead to acute limb ischemia and, if untreated, gangrene.
The danger of venous thrombosis lies in the detachment of a portion of the clot, which travels with the blood flow into the right chambers of the heart and subsequently into the pulmonary artery, causing a pulmonary embolism (PE). This is a life-threatening condition that can lead to sudden death.
Key Symptoms of Thrombosis
Thrombosis symptoms vary widely, depending entirely on the specific location where the clot has formed.
With deep vein thrombosis in the leg, the most common signs are swelling in one limb, a bursting sensation, the skin becoming warm, and redness in the area of the blockage. Pain is usually spasmodic, aching, and may worsen while walking, potentially radiating to the groin if the clot ascends higher.
If a clot enters the pulmonary artery, symptoms might include sudden shortness of breath, a stabbing chest pain, severe fatigue, dizziness, or fainting. Rapid pulse and quickened breathing are also common.
Arterial thromboses manifest differently. Coronary artery blockage presents as a constricting pain in the left side of the chest, often radiating to the arm or jaw. If a clot blocks cerebral vessels, sudden weakness on one side of the body, speech or vision impairment, unsteadiness while walking, numbness, or a sudden, severe headache may occur.
With thrombosis of limb arteries, symptoms develop rapidly. These include sharp pain, marked paleness and coldness of the skin, numbness, weakness, or a complete loss of movement.
If any of these symptoms appear, seek medical attention immediately.
How Thrombosis is Treated
If you suspect you have a venous thrombosis, the first step is to consult a vascular surgeon. Acute conditions (heart attack, stroke, PE) require hospitalization for treatment.
“There are several classes of medications used to treat thrombosis. Anticoagulants thin the blood. Antiplatelet agents prevent platelets from clumping together. Thrombolytics dissolve an already formed clot,” the specialist elaborates.
In certain scenarios, such as acute arterial thromboses blocking a vital artery, or in cases of mobile venous clots, surgical intervention might be necessary.
Thrombosis Prevention
Certain individuals maintain a perpetually high risk of thrombosis and must pay extra attention to their condition and adhere to preventive protocols. The primary high-risk groups include people with:
Varicose veins;
Diabetes mellitus;
Cardiovascular diseases (such as atrial fibrillation, heart failure);
Obesity;
As well as those who fly frequently or lead a sedentary lifestyle.
“During air travel, two factors operate simultaneously—prolonged immobility and the natural dehydration characteristic of high altitudes. Therefore, we advise wearing compression hosiery and drinking plenty of water. This prevents venous stagnation and blood thickening,” notes the doctor.
To prevent thrombosis, it is important to:
Increase physical activity. Walk regularly and perform stretches throughout the day, especially when working seated or during long flights.
Maintain a healthy weight.
Drink enough water to prevent the blood from becoming excessively viscous.
Quit smoking and limit alcohol—these significantly elevate risks.
Manage chronic conditions, particularly hypertension, diabetes, heart disease, and varicose veins.
Follow medical advice after surgeries and injuries. Anticoagulants or compression stockings may sometimes be required.
It is vital for women with a predisposition to thrombosis to discuss hormonal preparations (including contraception) with their physician.
The Main Points
A thrombus is a blood clot formed when the normal equilibrium between coagulation and free blood flow is disrupted. It can arise from dehydration, immobility, vascular damage, surgical procedures, hormonal medications, hereditary factors, or serious illnesses. Clots can form in both veins and arteries. Thrombosis is treated using anticoagulants, antiplatelet agents, fibrinolytics, and in complex cases, surgery. The choice of therapy depends on the cause of the clot formation. To minimize risk, it is crucial to increase movement, consume adequate water, manage chronic illnesses, wear compression stockings during flights, abstain from smoking, and discuss hormonal medications with a doctor.
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