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Stopping Clots Before They Stop You

The Annals of Cardiology No.34 | Stopping Clots before they Stop You

You can read the introduction below or read the full version here.

Every morning when I pull into the parking lot at 27 Point Finger Road, I go through a little ritual. I turn down the radio, roll up the windows, and switch off the ignition. Then I check my look in the rear-view mirror. Not to see if my hair is tame, but to see if I’m bleeding. That’s because a few minutes earlier I shaved, and I don’t want to breeze past my office manager, Liseta, with blood trickling down my lip. Let’s face it, when something’s bleeding we want a clot and we want it now. But as it turns out, human survival depends on a delicate balance between bleeding and clotting.

Let me explain. Our circulation is composed of miles of arteries, veins, and capillaries. I’ve been told that if you lay all those blood vessels out in a straight line, they would stretch out about 60,000 miles, or put another way, one person’s blood vessels could wrap all the way around earth 2.5 times. So with miles of vessels packed into one little body, you can imagine what a job it is to keep them all intact, especially when we’re always running into things that damage them. When a vessel is injured, the brain sends platelets – the sticky components of blood – to the site of bleeding and these, together with coagulation factors, aggregate to form a clot and stop the bleeding. Ingenious! So whether a vessel is punctured by a thorn in the garden, a carelessly-wielded disposable razor, or a knife in a dark alley, the ability to form a blood clot is life-saving.

But there are other threats to blood vessels beyond sharp objects in the environment. Sometimes things in our kidneys or bladder (stones, tumors, inflammation) can cause bleeding. Anyone who’s gotten up in the middle of the night to urinate and sees red stuff come out knows how alarming internal bleeding can be. Or sometimes a stomach ulcer or an intestinal diverticulum can start bleeding, turning your bowel movement into a crimson mess or – if the blood is first digested – into sticky black goo. Equally off-putting. Thank goodness blood knows how to form clots and stop bleeding when needed.

Continued in the full newsletter…

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