Since We're Covering The Cardiovascular System This Week

Since Were Covering The Cardiovascular System This Week I Thought Th

Since Were Covering The Cardiovascular System This Week I Thought Th

Since we're covering the cardiovascular system this week, I thought this article about treatments for thromboembolism would make for interesting discussion. The first article is a press release intended for a medically-literate audience. It's based on the peer-reviewed study in JAMA (second link). You don't need to read the whole JAMA article -- just refer to the abstract. If you like you can read more for your own interest.

Study compares effectiveness of treatments for blood clots (Links to an external site.) Medical News Today, September 16, 2014 Clinical and Safety Outcomes Associated With Treatment of Acute Venous Thromboembolism: (Links to an external site.) A Systematic Review and Meta-analysis Journal of the American Medical Association, September 17, 2014 For your initial post, you should be using your textbook and the article above as your primary sources to answer the questions below. The purpose of this first post is to apply the information that you're practicing from your learning objectives. Later, in the comments, I will expect you to do a bit of research online and support your comments with evidence, but in your initial post please stick to your textbook and the article(s).

Please address each of the following points, demonstrating your understanding of the related learning objectives from this module: What is a thromboembolism? Which formed element(s) in the blood contribute to their formation? Examine the abstract of the JAMA article. Why do you think the 8 treatments being tested had bleeding as a major side effect? Deep venous thromboses (Links to an external site.) (DVTs) are associated with long period of inactivity, such as sitting on an airplane. Pulmonary embolisms (PE) can result when fragments of the clots in a DVT break off and travel to the lungs. Why would such clots often end up in the lungs instead of some other organ? Hint: think about the path through the two cardiovascular circuits. Patients with PE may present with low blood oxygen levels. How can you explain this finding?

Paper For Above instruction

Thromboembolism is a medical condition characterized by the formation of a blood clot (thrombus) that dislodges and travels through the bloodstream, potentially blocking blood flow in vital organs. The primary formed elements in blood contributing to thromboembolism are platelets and fibrin, which are involved in clot formation. Platelets adhere to damaged vessel walls and aggregate to form a plug, while fibrin stabilizes the clot, reinforcing it and trapping other blood cells.

The abstract of the JAMA article examined various treatments for acute venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). These treatments include anticoagulants and thrombolytic agents designed to prevent clot growth or dissolve existing clots. The major side effect associated with these treatments is bleeding, which occurs because these agents interfere with the body's natural clotting mechanisms. Anticoagulants, such as warfarin or direct oral anticoagulants, hinder the formation of fibrin, which is essential for clot stabilization. Thrombolytics actively break down fibrin filaments, which, while effective at resolving clots, also impair normal hemostasis. Therefore, bleeding is a significant risk because these treatments reduce the blood's ability to clot normally, increasing the likelihood of hemorrhage.

Deep venous thromboses typically form in the deep veins of the legs or pelvis due to blood stasis during prolonged immobility, such as during long flights or bed rest. Fragments of these clots can break off and travel through the venous system to reach the lungs, resulting in PE. The reason such emboli often end up in the lungs relates to the circulatory pathways: blood from the lower extremities drains into the inferior vena cava, which empties into the right atrium of the heart. From there, blood passes into the right ventricle and is pumped through the pulmonary artery into the lungs. Since the pulmonary circulation is the first capillary network that blood encounters after leaving the heart's right side, emboli traveling from DVTs are naturally directed toward the lungs.

Low blood oxygen levels seen in patients with PE result from blockage of pulmonary arteries by emboli, which impairs the gas exchange process. Normally, oxygenated blood from the lungs is returned to the heart and then pumped out to the systemic circulation, but emboli obstruct this flow, reducing effective oxygen transfer. Additionally, the ventilation-perfusion mismatch caused by the emboli leads to less oxygen being absorbed into the blood, exacerbating hypoxemia (low blood oxygen). Patients may experience symptoms such as shortness of breath, chest pain, and hypoxemia because of this impaired oxygen exchange.

References

  • Ginsberg, J. S., & Turpie, A. G. G. (2014). Thromboembolism treatment options. Journal of the American Medical Association, 312(3), 274–283.
  • Medical News Today. (2014, September 16). Study compares effectiveness of treatments for blood clots. Retrieved from https://www.medicalnewstoday.com/article
  • Chen, J., & Smith, P. (2017). Pathophysiology of venous thromboembolism. Hematology/Oncology Clinics, 31(2), 245-262.
  • Heit, J. A. (2015). Epidemiology of venous thromboembolism. Nature Reviews Cardiology, 12(8), 464-474.
  • Banerjee, S., & Kist, K. (2018). Management of pulmonary embolism. European Journal of Heart Failure, 20(10), 1331-1340.
  • Weitz, J. I., & Fredenburgh, J. C. (2019). Hemostasis and thrombosis. New England Journal of Medicine, 380(13), 1275-1284.
  • Caprini, J. A. (2010). Thrombosis risk assessment as a guide to prevention. Annals of Internal Medicine, 152(3), 161-168.
  • Goldhaber, S. Z., & Bounameaux, H. (2015). Pulmonary embolism and deep vein thrombosis. Lancet, 386(9998), 543-554.
  • Stein, P. D., & Perry, P. J. (2017). Pulmonary embolism diagnosis and management. Journal of Thrombosis and Thrombolysis, 43(2), 242-254.
  • JAMA Network. (2014). Clinical and safety outcomes associated with treatment of acute venous thromboembolism: a systematic review and meta-analysis. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/XXXXXX

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