Arterial Thrombosis

Blood Clot, Fat Emboli, Air Emboli, Thrombus, Thromboembolism

What is thrombosis?

Thrombosis is the medical term for clot or the presence of a clot. An embolus is a piece of the clot that dislodges from the original clot formation and travels to other locations. The material that most often causes the obstruction is blood, but it can also be a piece of tissue, a clump of bacteria, a fat globule, or even an air bubble.

A thrombosis develops most often in the veins of the calves, the abdomen, or the chest, as blood flow is slower in the veins than in the arteries. This commonly occurs during the recovery period following major surgery. It is thought to be related to the trauma of surgery and/or the inactivity on the part of the individual as a result of the surgery. As emboli travel, they often lodge in the small vessels of the lungs, heart, kidneys, and brain. This can cause blockage (occlusion) of the vessel, tissue infarction, gangrene, and ultimately death.

How is it diagnosed?

Thrombosis signs and symptoms

The following depend on where the embolus lodges:

  • Brain: Temporary blindness, speaking difficulty, partial paralysis, hearing loss, headache and dizziness.
  • Extremities: Pain in the arm or calf after exercise (subsides with rest); weakness, numbness, burning and tingling sensations; weak or absent pulse beyond the blocked blood flow. These symptoms subside with rest.
  • Intestine: Abdominal pain, nausea, vomiting and shock.

History: Symptoms of an embolism do not usually appear until the clot obstructs or is unable to pass through a vessel. Physical symptoms may include severe pain at the site. If located in an extremity, the extremity may be numb or tingle, feel cold, and appear paler than normal.

Of special concern is a history of recent surgery, a blood clotting disorder, stroke or cardiovascular disease, and history of long-term intravenous therapy. These conditions should alert the physician and warrant further investigation.

Physical exam: Pulse sites normally felt in the extremity will be absent below the location of the clot.

Tests: Doppler ultrasound flowmeter, CT scan and laboratory blood tests (PTT, PT) determine clotting times.

How is thrombosis treated?

Blood thinning medications are immediately administered. Wrapping the affected limb will prevent loss of warmth and promote circulation. Direct heat is not applied as it may promote the development of gangrene. The extremity should not be massaged. Surgery to remove the clot and restore circulation as well as tissue or synthetic graft and repair of the vessel may be necessary.

Medications

Information Brand Generic Label Rating
Plavix online Plavix Clopidogrel Off-Label
Ibuprofen uses Motrin Ibuprofen Off-Label
Coumadin Warfarin Off-Label

What might complicate it?

Heart failure, venous stasis with long periods of bedrest or inactivity, and pressure on the veins of the legs or pelvis may cause complications.

Predicted outcome

With prompt diagnosis and treatment, outcome is favorable. Untreated conditions can be fatal.

Alternatives

Other diagnoses include muscle cramp/spasm due to dehydration or calcium deficiency and lactic acid build-up with excessive exercise.

Appropriate specialists

Cardiologist.

Seek Medical Attention

You or a family member has symptoms of arterial thrombosis or embolus. This is an emergency! Get medical help immediately.


Last updated 22 December 2011


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