Question

From the list of Virchow's triad can you think what risk factors might be responsible for (i) deep vein thrombosis following surgery (ii) coronary artery thrombosis and (iii) thrombosis of a cerebral artery leading to stroke.

Answer 1

VIRCHOW'S TRIAD-

The three factors responsible for the thrombosis are

1.Atherosclerosis due to the fibrofatty plaques in the intimal layers of the arteries and veins leading to thromboembolism.Atherosclerosis is a major initiator for thromboses related to abnormal vascular flow and loss of endothelial integrity.

2.Hypercoaguability of the blood due to lack of heparin and the excess of coagulating factors.with the development of the multiple thrombi,there is a rapid concurrent consumption of platelets and coagulation proteins and at the same time fibrinolytic mechanisms are activated and results in initial thrombotic disorder.

3.Stasis of the blood without any mobility in the intimal layers of the arteries and veins

a.Deep vein thrombosis following surgery-it may occur with stasis and in a variety of hypercoaguable states.

b.Coronary artery thrombosis is obvious to occur with stasis in the venous circulation and myocardial infarction may be associated with dyskinetic contraction of the myocardium as well as damage to the adjacent endocardium providing a site for the origin of mural thrombus.

c.Thrombosis of the cerebral artery leading to stroke is due to atherosclerosis or thromboembolism where the emboli are dislodged from a distance sites and settles in the brain leading to obstruction of the blood flow to the brain causing a nerolytic stroke or paralysis.