All you need to know about blood clots

Blood clots

Blood clots are common, preventable and even treatable especially if discovered early.

Photo credit: Fotosearch

What you need to know:

  • In a human body, blood clots commonly occur in the brain, lungs, legs, arms and the abdomen
  • Visible or superficial blood clots known as thrombophlebitis can come about as a result of varicose veins
  • There are different ways of diagnosing blood clots depending on one's blood type.

The buzz around blood clots is current, but it is not new.

Blood clots have always existed and are double-edged. They can either be good or bad. A blood clot is formed to prevent excessive bleeding. On the other hand, depending on how it occurs, it may cause serious health complications or even death.

The latest debate is on the rare blood clots reported amid Covid-19 vaccination and is now threatening the drives.

As at now, investigations are still ongoing to find out if there is a connection between the reported blood clots to the AstraZeneca and Johnson & Johnson vaccines.

Kenya only has the AstraZeneca vaccine and so far, and the Health ministry has not reported any case of a blood clot yet. The government is also in talks with the African Union facility to procure the Johnson & Johnson vaccine.

Apart from these two vaccines being linked to cases of rare blood clots, other common denominators is that they use the viral vector (genetically modified virus) technique and are stored using a regular fridge temperature. The two only differ in the number of doses to be administered.

An explainer published at the scientific journal Nature alludes to the clots resulting from the two vaccines having occurred at the lower abdomen or the brain.

Researchers, however, have not established what component of the vaccine causes the clotting.

The blood clots' characteristics, the Nature article explains “are coupled with low levels of platelets, cell fragments that aid blood coagulation (clotting)".

Post-injection effect

Dr Etau Ekwom, a rheumatologist, says blood clots are common, preventable and even treatable especially if discovered early.

In a human body, blood clots commonly occur in the brain (cerebral venous sinus thrombosis), lungs (pulmonary embolism) and the leg or arms (deep vein thrombosis) and the abdomen (splanchnic vein thrombosis).

“If a blood clot occurs above the knee (proximal deep vein thrombosis), it has a high risk of dislodging from the vein and moving to the lungs which could be fatal and it causes pulmonary embolism,” Dr Etau explains.

Visible or superficial blood clots known as thrombophlebitis can come about as a result of varicose veins (occurs when veins bulge or twist), or a post-injection effect which causes swelling and pain resulting in a slowed down blood flow.

Blood clots can be caused by a number of factors, some of which include long flights or travel, some medical conditions, using contraceptives that have high oestrogen hormones and also being bedridden for a long time.

“The vein allows blood to flow from your feet all the way to the heart. So if your vein is blocked, blood will not flow and you will not have a backflow and that makes the vein swell,” Dr Etau explains.

“That is why if you are going to fly for long hours, say from Kenya to New York, while on board you are likely to be advised to walk around. That stops you from getting blood clots in your leg,” he adds.

Symptoms of blood clots in different parts of the body

Brain

Increased pressure within the brain, severe headaches, blurring of vision, convulsions or fainting episodes

Leg or Arm

Swelling, pain or tenderness not caused by injury, skin that is warm to the touch, redness or discolouration of the skin

Lungs

Difficulty in breathing, chest pains which escalates when one takes a deep breath, coughing blood, fast heartbeat, features of heart failure, shortness of breath

“Pulmonary embolism (blood clots in the lung) can also cause straining of the right side of the heart and if it is not recognised early it can lead to heart failure,” Dr Etau explains.

Abdomen

Severe abdominal pain, blood in stool, nausea, vomiting, diarrhoea and bloating

Diagnosis

There are different ways of diagnosing blood clots depending on one's blood type.

 “The first thing one has to do is to diagnose the disease and then most of them are treated with anti-coagulation medicine,” he says.

The treatment options for people diagnosed with blood clots include the use of anticoagulants or blood thinners. The use of blood thinners reduces the ability of the blood to clot and it also prevents the already formed clot from enlarging by reabsorbing it. In the end, it lessens the risk of formation of other clots.

Anticoagulants can either be injected or taken orally.

The other treatment option that is advised by the Centres for Disease Control and Prevention (CDC) is the use of thrombolytics.

“They (thrombolytics) work by dissolving the clot but have a high risk of causing bleeding and so they are reserved for severe cases,” explains the CDC.

A surgical procedure used in removing the clot (thrombectomy) can also be another treatment option.

If all the options fail, physicians can use an inferior vena cava filter, a procedure which introduces a filter inside a vein to trap the clot before it gets to the lungs.