In a thrombosis, a vein is partially or completely closed by a blood clot. There can be various causes for this. It is important to differentiate the concept of deep vein thrombosis from arterial thrombosis. Because this creates a blood clot in a vein, which can result in a heart attack or stroke. Read how thrombosis develops and how to lower your risk of thrombosis.
Bedridden people and smokers who take the birth control pill are at particular risk. Also, various diseases and certain medications can increase the risk of thrombosis. Here you can find out what causes thrombosis and how you can use preventive measures to lower your risk of thrombosis.
This creates a thrombosis
Three factors play a role in the development of deep vein thrombosis:
- Damage to the vascular wall - such as through phlebitis, injury or surgery - activates the platelets and thus promotes their clumping into a clot.
- A turbulence or slowing of the bloodstream, for example in varicose veins or long bed restraint also causes the platelets accumulate more and more. So it is also to explain that after long journeys by plane, train or car the Thrombosegefahr is increased. Because when you sit for a long time, the popliteal vein is bent, which reduces blood flow in the legs.
- A change in the blood composition may favor the development of thrombosis. This can be done by various hereditary diseases with a tendency to clotting (thrombophilia) or by malignant tumors. On the other hand, a lack of fluid ("dehydration") can make the blood more viscous, which also makes it easier to form blood clots.
Resting and bed-rest as causes
An important risk factor for the development of thrombosis is the immobilization of extremities, such as after surgery or injury. Because of the lack of muscle activity, the return of the blood is slowed down and it can easily form clots.
Therefore, patients who are lying in bed for a long time due to illness or after surgery or who are wearing a cast are usually prescribed thrombosis injections. Even with severe heart failure or chronic venous insufficiency, there is a slower blood flow in the veins, which promotes thrombosis.
Dangerous combination: smoking and anti-baby pill
Hormonal factors can also contribute to the development of thrombosis. For example, the female sex hormone estrogen has an influence on certain coagulation factors, which makes the blood easier to clot.
Therefore, pregnant women and women who are using estrogen-containing drugs such as the birth control pill or the vaginal ring, an increased risk of thrombosis. This is also significantly increased by smoking, because nicotine also contributes to the activation of blood clotting.
Thrombophilia: Disease with risk of thrombosis
Thrombophilia refers to an increased tendency to clot, which is associated with an increased risk of thrombosis. Some of these coagulation disorders are hereditary - usually it is a gene defect in the coagulation system. Other thrombophilies do not develop during the course of life, perhaps as a result of other diseases such as cirrhosis or as a side effect of heparin therapy.
Also, blood disorders such as polycythemia vera or essential thrombocythemia, in which the number of platelets is increased, bring with it an increased risk of thrombosis.
In addition, the following factors can contribute to an increase in the risk of thrombosis:
- strong overweight (obesity)
- Taking certain medications for the treatment of mental illness (neuroleptics)
- Chronic obstructive pulmonary disease (COPD) and other impaired lung function
- Heart attack
- Stroke with paralysis as a result
- a thrombosis in the past
Reduce risk - actively prevent thrombosis
In order to prevent a thrombosis, there are various possibilities that can only be used with an increased risk of thrombosis:
- Mobilization: After a condition or surgery has been overcome, bed rest should only be observed if absolutely necessary, and physiotherapy should be started early. It is important to discuss with your doctor or physiotherapist how much you are allowed to exercise.
- Compression: bedridden patients are usually prescribed thrombosis stockings during hospitalization. For people with an increased risk of thrombosis, it may be useful to wear compression stockings in everyday life.
- Thrombosis injection: If there is a limited capacity of a limb after injury or surgery, usually a drug thrombosis prophylaxis with anticoagulant drugs is carried out for a few weeks. In most cases, heparin is used, which is injected once or twice daily under the skin. Newer anticoagulants such as rivaroxaban or dabigatran are also available in the form of tablets.
- Anticoagulant: After a thrombosis is over, a long-term therapy with so-called vitamin K antagonists such as marcumar is usually started to prevent a relapse. These drugs inhibit the vitamin K-dependent formation of certain coagulation factors and can thus prevent the development of a new thrombosis.
- Thrombophilia diagnosis: If thrombosis occurs repeatedly in younger patients, diagnostics to exclude thrombophilia or other conditions may be useful.
- Gymnastics: For long-haul flights or long car, bus or train journeys, you should pay attention to regular exercise to prevent thrombosis. Get up on the plane as often as possible and if possible, take a few steps. You can do simple exercises on your seat: quickly switch between stretching and putting on your feet for 30 seconds, or try lifting things off the ground with your toes. Get off the car during breaks and do some loosening and stretching exercises.
Switch off risk factors
Minimize your risk of thrombosis as much as possible: If you are a smoker and you can not or will not quit smoking, you should use an estrogen-free contraceptive method wherever possible. This is best advised by your gynecologist.
If you are overweight, you should try to lose a little weight - so you generally do something good for your health.