Posts Tagged ‘Stroke’
Stephan Moll, MD writes… Women are at increased risk for blood clots (DVT, PE, stroke and heart attacks) during pregnancy and in the weeks after delivery. If the risk is high enough, then preventive blood thinners (anticoagulants) are recommended, such as in a woman with a history of a previous blood clot. Guidelines exist as to which woman should be considered for blood thinners (ACOG 2012 guideline; ref 1).
The period after delivery is a particularly high-risk period for forming blood clots. It has typically been defined as being the 6 weeks after giving birth. Therefore, if blood thinners are chosen after delivery, they are classically given for 6 weeks. A study recently published in the New England Journal of Medicine (ref 2) examined whether the risk for blood clots is increased only for 6 weeks postpartum or whether the risk persists beyond the first 6 weeks. Read the rest of this entry »
Some people have a “hole in the heart”, called a “patent foramen ovale” (PFO). This is a connection between the right and the left chamber (atrium) of the heart. We are all born with it – the unborn needs this connection for proper blood circulation. In most people the hole closes in the first few weeks after birth. However, in up to 25 % of people it stays open, equally often in men and women. A PFO usually does not cause symptoms. However, when a person has an acute DVT (deep vein thrombosis) and a clot breaks off and travels with the blood stream, it may cause problems.
DVT and PE in the person without PFO
In the person who does not have a PFO, a clot that breaks off from a DVT travels with the blood stream through the main vein in the abdomen to the chambers of the right side of the heart (color blue in figure 1 and 2). From there, it travels into the lung vessels, where it gets lodged, causing a pulmonary embolism (figure 1).
Stephan Moll, MD writes…
Sinus and cerebral vein clots are uncommon. They can lead to severe headaches, confusion, and stroke-like symptoms. They may lead to bleeding into the surrounding brain tissues. The clot can be triggered by infections of the ear, face, or neck, by estrogen use and pregnancy, and can be caused by inherited and acquired clotting disorders. The diagnosis is, unfortunately, sometimes initially missed by health care professionals, as a plain CT or MRI of the head can be normal. Read the rest of this entry »
Stephan Moll, MD writes…
Arteries are the blood vessels that lead blood away from the heart into the periphery, i.e. to the extremities, the brain, the abdominal and pelvic organs. They deliver oxygen to organs and muscles. Veins lead the blood back to the heart, from where it flows into the lung to take up fresh oxygen. Blood clots in arteries can lead to stroke (so called ischemic stroke), heart attacks, or gangrene of the extremities. Blood clots in veins are called superficial thrombophlebitis, deep vein thrombosis (DVT), and pulmonary embolism (PE). Read the rest of this entry »
A recent summary of all published good quality trials (randomized, placebo-controlled) shows that taking vitamin E supplements slightly increases a person’s risk for bleeding into the brain (reference 1). My conclusions: (a) I caution against the use of daily vitamin E supplementation, and (b) I advise against the use of vitamin E in patients who are already at a higher risk for bleeding, such as those who are on a blood thinner (warfarin and others) or an anti-platelet drug (aspirin, Plavix® and others). Read the rest of this entry »