Thrombus Formation

Write a short note on factors involved in thrombus formation.
Answer:

Thrombosis is the process of formation of solid mass in circulation from the constituents of flowing blood, the mass itself is called as thrombus.

Factors Involved in Thrombus Formation

There are three major contributors:

Endothelial injury: It can be secondary to:
- Myocarditis
- Myocardial infarction
- Cardiac surgery
- Ulcerated atherosclerotic plaque
- Infected valve disease
- Prosthetic valves
- Radiation injury
- Chemical agents such as smoking, hypercholesterolemia etc.
Alteration in normal blood flow: It leads to
- Disruption of laminar flow
- Damage to endothelium
- Decreased hepatic clearance of activated coagulation factors
Conditions predisposing to hypercoagulability..

Thrombus formation steps

It is divided into two, i.e. genetic and acquired factors. Some of the genetic factors which predispose to hypercoagulability are:

Deficiency of anti-thrombotic factors, i.e. anti-thrombin 3, protein C and S, and defects in fibrinolysis.
Increase in prothrombotic factors such as in factor 5 mutation, high level of factors 7, 9, 11, 8, Von Will brand factor, and fibrinogen.

Virchow’s triad thrombosis

Some of the acquired factors which predispose to hypercoagulability are:

Venous stasis: It is due to prolonged immobilization and congestive cardiac failure.
Increased platelet activation: In cancers, acute leukemias, myeloproliferative disorders, paroxysmal nocturnal hemoglobinuria, prosthetic cardiac valves, atrial fibrillation, etc.
Due to increased hepatic synthesis of coagulation factors or reduced anticoagulant synthesis due to oral contraceptives and in pregnancy.
Due to tissue injuries such as in surgery, fracture, and extensive burns.

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