Talk:Thrombosis

Added Dangerous? Section

I added the section called "Dangerous?" to differentiate between the type of thrombosis that can kill you vs. those that are innocuous but more likely to occur. My experience was that I had a superficial thrombosis which was not dangerous but all the information on the web regarding thrombosis/blood clots goes pretty quickly to "stroke, pulmonary embolism, heart attack, DEATH". So I blew an ER visit on finding out the difference between the two. Thought this would be helpful to people who will end up here to allay fears about the harmless versions. I put it near the top so that people who are trying to self diagnose would find it quickly. Hope I'm conforming to conventions and not stepping on any toes. — Preceding unsigned comment added by Bthegoodwin (talk • contribs) 00:42, 2 August 2011 (UTC) Bthegoodwin (talk) 00:59, 2 August 2011 (UTC)

Busted Image?

I removed a stray/malformed image tag. I didn't see the image filename so I couldn't correct it.

med adv

I had a blood coming out of my penis while ejaculating....does anybody know what that is???????

Well, this page is about clots, not fresh blood. Please see your own doctor, and do not ask these questions in a public forum where every crank can give you bogus advice. JFW | T@lk 08:02, 22 Jun 2005 (UTC)

Arm Clot

I had surgery (lumpectomey w/ node removal) for breast cancer on 12/20/06. I am now in radaition treatments. Today they discovered two blood clots in my arm (the same as the side of breast cancer and node removal). They are treating me with herceptin(?) and coumadin. So many people have told me to be very careful and not break the blod clots as they could cause either a heart attack or brain anyerism(sp), both of which could be fatal.

Is this really true? Is this really that serious?

maximinkMaximink 08:05, 22 February 2007 (UTC)

Hmm... It is always good, when the patient tries to understand, what his MD is doing... If u doubt, that u understood ur doctor of medicine correctly (or even that he understood ur condition correctly), u should seek further counseling with ur family doctor (or if necessary with another MD)... If ur health insurance does not cover a second/third opinion, u can possibly ask the local health authority for assistance... --Homer Landskirty 18:42, 5 March 2007 (UTC)

I don't know if this will still be helpful, but yes, this is considered a risk if you currently have a clot (also called a 'thrombus'). If you have a clot in your veins that won't break up and it gets disconnected from where it is attached in your arm, the next stop is your heart and brain. If it gets to your heart, it can stop blood, causing a heart attack; if it gets to your brain, it can stop blood, causing a stroke. HOWEVER, are these clots still even there? They should have given you a drug or done surgery to get rid of the clots. Once they are gone, I do not believe you do not have to worry about accidentally breaking them up, right? And if you are on coumadin, I think they must have done something to get rid of those clots. Ask your medical provider and find out about those clots.

You said you are on herceptin for this...hmmm. Well, herceptin is for breast cancer. So I bet you are on herceptin for breast cancer and just coumadin for the clotting. Coumadin does not break up clots, it keeps you from forming new clots. You do have to be careful when you are on coumadin b/c you can't stop bleeding as well if you get hurt (because of that whole anti-clotting thing).

All of this information is given as a student nurse and is not meant to be taken as medical advice, just to explain the patho in plain language--see your doctor!!

Shula100 12:31, 8 November 2007 (UTC)

Dehydration //Lisa McPherson

I wonder, if Virchow's triad covers dehydration as a source (maybe "composition of the blood")... Vis-a-vis L. McPherson (the scientologists say, that dehydration cannot cause thrombosis...; the attorney of a relative of McPherson says, that dehydration can cause thrombosis; the GERM wikipedia (de:Thrombose) says, that dehydration can cause thrombosis; and IIRC a paper in the seat pocket in an aircraft told me, that dehydration can cause thrombosis)... The article here does not say, if thrombosis can be caused by dehydration... at least not as clearly as I would like it... Even if it is proven, that dehydration cannot cause thrombosis, we should mention that in the article for maximum clarification... Thx. --Homer Landskirty 18:48, 5 March 2007 (UTC)

I found this: deep venous t. -- it says clearly, that thrombosis can be caused by dehydration in combination with immobility... So I obviously misinterpreted the statement of the scientologists... --Homer Landskirty 20:24, 5 March 2007 (UTC)

All other factors which causes thrombosis are fundamentally based on Virchow's Triad. And take note that the triad consists of only 3 primary factors not more than that, that is why it is called a triad (meaning 3). For example immobility and dehydration (if it leads to the change of viscosity of blood) may cause the disturbance of blood flow in veins (one of Virchow's triad) which will lead to DVT (Deep Vein Thrombosis). This is simply because blood with a lower content of water is thicker and has a different concentration of elements and venous blood flow relies very much on muscular contraction which is impaired by immobility. -Teoh 2007

Sports

Venous thrombosis less common in those with participate in sports doi:10.1111/j.1538-7836.2007.02732.x JFW | T@lk 06:43, 15 August 2007 (UTC)

Virchow's Quadrate

I do not think a Virchow's Quadrate exists. I've only heard of the Virchow's Triad. Can anyone explain? —Preceding unsigned comment added by Drteoh (talk • contribs) 19:27, 9 November 2007 (UTC)

Vandalism

I doubt that Reginald VelJohnson was the one that coined the term, considering he is an actor that was not alive during the year listed.JoeyFNK (talk) 02:58, 27 December 2007 (UTC)

Malignancies

Malignancy is more common in VTE, with the usual suspects standing out: ovary, pancreas etc http://www.blackwell-synergy.com/doi/abs/10.1111/j.1538-7836.2008.02928.x JFW | T@lk 08:38, 16 April 2008 (UTC)

MCOTW summary

This vital article (I have changed the importance to "top") is presently in a ghastly state, which is always a good thing when MCOTW comes crashing in with power tools.

• We need to avoid going into individual thrombotic conditions, as they are suitable dealt with on their own pages. We do need to mention them all, and make the important distinction between arterial and venous thrombosis and atherothrombosis (which are different disease processes), micro- and macrovascular thrombosis and red and white clots.
• Careful delineation with platelet and coagulation is needed. A good general source is needed that focuses on the interplay between vessel wall, platelets, coagulation proteins and fibrinolysis, rather than one particular aspect of the disease process.
• There is not a word on diagnosis and treatment yet. For diagnosis, some generalisations about FDP and D-dimer and widely used imaging modalities are probably sourceable. For treatment, there are piles and piles of high-quality reviews and guidelines available.
• I'm not sure if the WP:MEDMOS outline should be adopted.

Let's see how this one goes. JFW | T@lk 06:28, 13 July 2008 (UTC)

Sorry, FDP=? —KetanPanchal^taLK 12:51, 14 July 2008 (UTC)

FDP=Fibrin degradation products. It's a marker of thrombus turnover. Axl (talk) 18:02, 22 July 2008 (UTC)

Background reading

http://asheducationbook.hematologylibrary.org/cgi/content/full/2005/1/1 - is an excellent introduction on venous thrombosis by Rosendaal. JFW | T@lk 22:49, 13 July 2008 (UTC)

Another "Cause" to consider

I think the article would be improved with some expansion to the section on Causes. The serpinopathy section of another article claims that "Well characterised serpinopathies include emphysema, cirrhosis, thrombosis and dementia." and provides a citation. I suspect there may be other causes as well, but was surprised to find this article mentioning nothing on it at all about the serpin connection that has apparently now been established.N2e (talk) 19:06, 19 July 2008 (UTC)

Following on to your edits to cirrhosis and Talk:dementia: I think you misunderstand the comment on the serpin article. It refers specifically to the condition antithrombin III deficiency, which is indeed the result of a serpin deficiency and does indeed predispose to thrombosis. JFW | T@lk 13:57, 20 July 2008 (UTC)

New guidelines are here!

Couldn't be more timely. Free full text --Steven Fruitsmaak (Reply) 19:29, 22 July 2008 (UTC)

This is a summary of almost 1000 pages of guidelines (TOC of Chest supplement). What a monster effort that must have been. Ridiculously, apart from the summary these articles are not actually available free. I am in full agreement with the respondent in the E-letters (URL) who feels that this is a ridiculous situation that will interfere with the effective implementation of said guidelines. JFW | T@lk 06:28, 25 July 2008 (UTC)

On the other hand, the first recommendation on prophylaxis is: hospitals should develop their own guidelines. --Steven Fruitsmaak (Reply) 20:49, 25 July 2008 (UTC)

In the UK we are patiently awaiting NICE to extend their guidelines to medical patients in addition to surgical ones. JFW | T@lk 22:08, 27 July 2008 (UTC)

You mean you are continuing the epidemic... --Steven Fruitsmaak (Reply) 08:51, 29 July 2008 (UTC)

No, we are presently working on the Chief Medical Officer's interim recommendations. JFW | T@lk 22:01, 18 August 2008 (UTC)

Weight

Having suffered a VTE and being overweight or obese almost doubles the risk that it will happen again: http://archinte.ama-assn.org/cgi/content/abstract/168/15/1678 JFW | T@lk 22:00, 18 August 2008 (UTC)

Excessive Exercise - possible cause?

When I was a child, I used to read a lot of "real life medicine" stories and one which stuck out involving a lady who exercised compulsively (I believe the story involved her substituting exercise for prior over-eating) and the sheer number of thigh exercises she did lead to a thrombus in her thigh which started blocking all blood flow. I thought I remember a similar story in the "The Dark Side of the Moo" article on Chung Moo Quan, but it turns out that was a case of compartment syndrome. Anyone with more knowledge know whether it's plausible that the first case was indeed an exercise-related thrombus? I'm afraid the only other case I remember clearly involved a girl overdosing on a particular type of carotene supplements which were being marketed as FDA-approved tanning pills (They were FDA approved, but only for food dye and at much lower dosages). -67.171.65.251 (talk) 02:23, 17 March 2011 (UTC)

Mixed bag: venous and arterial articles

I note the following:

• wikipedia.org/venous_thrombosis goes to its own article
• wikipedia.org/arterial_thrombosis redirects to "thrombosis" article

I know the difference between "venous" (in the vein) and "arterial" (in the artery).

This article contains information about both "venous" and "arterial" thrombosis. It seems to me that this would be a better structure:

• split off the "venous thrombosis" parts of this "thrombosis" article and merge with the existing "venous thrombosis" article
• new "wikipedia.org/wiki/arterial_thrombosis article which includes the arterial-specific portions of this article
• the stripped-down "thrombosis" article should remain at wikipedia.org/wiki/thrombosis to serve as an overview with links to the venous_thrombosis & arterial_thrombosis articles — Preceding unsigned comment added by 67.230.129.115 (talk) 19:00, 20 September 2011 (UTC)

Hypoxia

The link to hypoxia should probably be more correctly linked to ischemia . — Preceding unsigned comment added by Taxtropel (talk • contribs) 20:15, 15 February 2012 (UTC)

Recommendations of prevention in cancer outpatients

By ISTH doi:10.1111/jth.12725 JFW | T@lk 19:24, 16 September 2014 (UTC)

Leukocytes are not bystanders

doi:10.1182/blood-2016-05-718114 JFW | T@lk 11:21, 12 August 2016 (UTC)

Folate

Some content was added about folic acid deficiency being a risk factor for thrombosis by elevating homocysteine. Firstly, it was added to the opening paragraph on the pathogenesis, whereas hyperhomocysteinaemia still fits within Virchow's triad. Secondly, I am not aware of good epidemiological evidence that folic acid deficiency is actually associated with increased thrombosis risk. Biochemical plausibility does not mean real world association. JFW | T@lk 08:59, 2 December 2016 (UTC)

Not really

from the article: "However, thromboprophylaxis can lead to complications such as bleeding. There are new, non-invasive ways to stratify bleeding risk for patients with VTE and PE, by using tools like the RIETE Registry. The RIETE registry is an interactive database which uses data from previous and current patients, even groups not typically recruited like women and elderly as well as those with pre-existing conditions like Cancer or renal failure. The RIETE Registry offers more personalized options for patients with clotting risk, and it also has created a predictive calculator based on the registry's findings.[31]" I looked at the reference and it is a calculator of risk ONLY for thromboembolism, not thrombosis. (We all know the difference, right?). I will wait for comments before moving it to thromboembolism. Best Regards,

Barbara (WVS) (talk) 12:21, 20 December 2016 (UTC)

"Thromboprophylaxis" is used almost exclusively for venous thromboembolism. It needs covering here very briefly, because most readers use "thrombosis" and "VTE" interchangeably. JFW | T@lk 16:40, 20 December 2016 (UTC)

What you are saying is very true...but for clinicians. Readers think 'blood clots' and 'blood clots in the lungs'. You mention 'thrombosis' to a regular kind of reader and you might get a blank look. What I've been reading in my texts and online indicates a move toward a more general approach to preventing blood clots in all settings and bodily locations. Even in the references you recommended to me illustrate this. In my opinion (worth nothing in the context of writing articles), some of the confusion in assessing risk is based upon the Well's test being the standard. But this assessment is based upon previous history of DVT and not really takes into account those who do not have a history of DVT or VTE. The CDC recognizes the need for prophylaxis WAY before the development of DVT and VTE and have described this on their website. Your comments are valued and I look forward to continuing this discussion. The Very Best of Regards,

Barbara (WVS) (talk) 12:56, 1 January 2017 (UTC)