THROMBOSIS

• Def
Process of blood clotting in blood
vessels and cardiac.
 CAUSES >VIRCHOW’S TRIAD

Rudolph
virchow’s
Triad over a
century ago
 1. ENDOTHELIAL INJURY
• Loss of protective and anticoagulant factors (PGI2, t-PA,
thrombodulin)

• Expression of adhesive molecules and enhancement of

procoagulant factos (Tissue factors, PAI)
• Injury in endotheliam exposes subendothelial which causes
imbalance in anti and procoagulant factors.
• Any source that causes imbalance in anti and procoagulant factors
is responsible for thrombosis
 CAUSES OF ENDOTHELIAL INJURY

• Hypertension . Turbulent flow

• Radiation injury . Metabolic abnormalities
• Smoke . Bacterial products

Example of thrombosis due to endothelial injury

Thrombi in heart after myocardial infarction

2. ABNORMAL BLOOD FLOW
• Turbulence flow of blood as well as counter current cause endothelial injury or
dysfunction that cause thrombosis .
• Stasis is Major factor of thrombosis due to abnormal blood flow.
• normally platelets are in center of lumen and are separated by
endothelium from slower moving plasma
• Abnormally or by contrast stasis and turbulent flow has deliterious
effects .
1. Both promote coagulant activity .
2. Stasis allows platelets and leukocytes for adhesion with endothelium.
3. Stasis slows washout of activtated clothing factors.
 3. HYPERCOAGULABILITY
• The term “hypercoagulability” is used to
describe patients who are at increased risk for
thrombosis because of inherited defects in their
anticoagulant pathways or because of various
predisposing causes. About one in five patients
of European descent who present with venous
thromboembolism have a specific genetic defect
in their anticoagulant pathway
 TYPES OF
HYPERCOAGULABILITY
1. Primary (genitic) 2. Secondary (acquired)