Arterial thrombosis (brief)

Question 1

What causes it?

Answer 1

Solid mass in the circulation from the constituents of the blood during life. Emboli may break off and block vessels further down. Arterial thrombosis is usually the result of atheroma, which forms particularly in areas of turbulent blood flow, such as the bifurcation of arteries. Platelets adhere to the damaged vascular endothelium and aggregate in response to ADP and thromboxane A2. This may stimulate blood coagulation, leading to complete occlusion of the vessel, or embolism resulting in distal obstruction. Arterial emboli may also form in the LV after MI, in the LA in mitral valve disease, or on the surface of prosthetic valves.

Question 2

How does it present?

Answer 2

the 6Ps.

Pallor, paralysis, pulselesness, paraesthesia, pain, persishingly cold.

Question 3

Treatment

Answer 3

Antiplatelet drugs, e.g. Aspirin, dipyridamole, clopidogrel among others for prevention. Thrombolytic therapy. Streptokinase is a purified fraction of the filtrate obtained from cultures of haemolytic streptococci. Tissue-type plasminogen activators such as recombinant alteplase (t-PA) can be used and unlike streptokinase do not cause allergic reactions.