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Hemodynamic Disorders, Thromboembolic Disease & Shock-HYPERCOAGULABLE STATES (THROMBOPHILIA)
Hypercoagulable states, also known as thrombophilia, are conditions that increase the risk of developing venous thrombosis. There are hereditary and acquired causes of thrombophilia. Microscopically, red thrombi found in veins contain more red blood cells, platelets, and leukocytes trapped in a fibrin meshwork, resembling blood clots. Over time, a thrombus may resolve through fibrinolysis, organize by developing connective tissue, propagate by continued deposition, or embolize to cause blockages elsewhere.
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Hemodynamic Disorders, Thromboembolic Disease & Shock-HYPERCOAGULABLE STATES (THROMBOPHILIA)
- 1. Hemodynamic Disorders, ThromboembolicDisease & Shock- HYPERCOAGULABLE STATES (THROMBOPHILIA) DR. ROOPAM JAIN PROFESSOR & HEAD, DEPT. OF PATHOLOGY
- 2. 5. HYPERCOAGULABLE STATES (THROMBOPHILIA) •Thrombophilia or hypercoagulable states are a group of conditions having increased risk or predisposition to develop venous thrombosis. • These conditions may be hereditary (or primary) or acquired (or secondary) causes.
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- 4. Distinguishing features of arterial& venous thrombi
- 5. CAPILLARY THROMBI • Minutethrombi composed mainly of packed red cells are formed in the capillaries in acute inflammatory lesions, vasculitis and in disseminated intravascular coagulation (DIC).
- 6. Morphologic Features • Grossly, •thrombi may be of various shapes, sizes and composition depending upon the site of origin. • Arterial thrombi tend to be white and mural while the venous thrombi are red and occlusive. Mixed or laminated • Thrombi are also common and consist of alternate white and red layers called lines of Zahn. • Red thrombi are soft, red and gelatinous whereas white thrombi are firm and pale.
- 7. Morphologic Features • Microscopically, •the composition of thrombus is determined by the rate of flow of blood i.e. whether it is formed in the rapid arterial and cardiac circulation, or in the slow moving flow in veins. • Red (venous) thrombi have more abundant red cells, leucocytes and platelets entrapped in fibrin meshwork. Thus, red thrombi closely resemble blood clots in vitro.
- 8. Thrombus in anartery. The thrombus is adherent to the arterial wall and is seen occluding most of the lumen. It shows lines of Zahn composed of granular-looking platelets and fibrin meshwork with entangled red cells and leucocytes
- 9. Distinguishing features ofantemortem thrombi & postmortem clots
- 10. Fate of Thrombus 1.RESOLUTION • Thrombus activates the fibrinolytic system with consequent release of plasmin which may dissolve the thrombus completely resulting in resolution. 2. ORGANISATION • If the thrombus is not removed, it starts getting organised. 3. PROPAGATION • The thrombus may enlarge in size due to more and more deposition from the constituents of flowing blood. • In this way, it may ultimately cause obstruction of some important vessel. 4. THROMBOEMBOLISM • The thrombi in early stage and infected thrombi are quite friable and may get detached from the vessel wall. • These are released in part or completely in blood-stream as emboli which produce ill-effects at the site of their lodgement.
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