This series is about the multiple medical conditions that are related to metabolic syndrome (MetS). For the definition of MetS and the diseases commonly associated with it, refer to Part 1. Part 2 presents the pulmonary, genitourinary, and reproductive organ manifestations of MetS. Part 3 shows the link of MetS to gout, obstructive sleep apnea, and eye problems. This article, Part 4, is about how MetS affect the clotting of the blood and since all body organs need a constant supply of blood, any disruption in the venous and arterial side can potentially decrease functionality and can lead to loss of life and limb.
Coagulation Problem
Deep Venous Thrombosis
Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE). Clotting problems commonly found in the deep veins of the extremities manifest as (DVT). It manifests as swelling of the legs. When the blood clot gets dislodged and travels in the bloodstream and end at the lungs, it becomes PE. The blood clot in PE blocks the blood supply going into the lungs and thus cannot deliver oxygenated blood to the whole body. PE manifests commonly as chest pain and shortness of breath.
Atrial Fibrillation
Atrial fibrillation, (Afib) is also a manifestation of MetS and will be discussed in a later article, can also result in blood clot formation inside the heart. The fibrillation of the atrial chambers creates a churning motion conducive to clot formation. Also, the MetS create a pro-clotting milieu, that creates an environment conducive to clot formation.
Unwanted Blood Clots Develop in AFib
Clot formation inside the Afib heart becomes a disaster when the clot gets dislodged and travels to the brain and produce a stroke. Afib can manifest as a rapid and irregular heartbeat or palpitations. More often than not, a person may not feel any palpitations. The clot inside the heart is also asymptomatic while it forms and then announces its presence with a bang once a stroke happens. When a blood clot forms, it is a thrombus. If the thrombus gets dislodged and gets carried by the bloodstream, then it becomes an embolus. Since they occur together, they are called thromboembolus.
Blood Clots Can Cause Problems All Over
Afib patients who are not on blood thinners or are not anticoagulated are prone to develop thromboembolism. The emboli that are formed in the heart can go anywhere in the body and manifest differently depending on the organ involved. If it ends at the brain, then it can be a TIA or a CVA (see below). If the clot blocks an artery to the kidney, then renal failure ensues. If it goes to the arteries supplying the intestines, then Acute bowel ischemia occurs that manifest as abdominal pain, what needs immediate surgical. Clots migrating to the arteries of the eyes present as transient blindness and is a type of stroke called Amaurosis Fugax. That is why Afib patients need to be on blood thinner medications. Once you are on the blood thinners, then regular blood testing is necessary if warfarin is prescribed. You want your blood to be watery enough to prevent blood clot formation but not too thin that it may make you bleed from the nose, intestines, or the brain. Another group of blood thinners called direct thrombin inhibitors like dabigatran are convenient to take because it does not need regular blood work for monitoring.
The Problems with Blood Thinners
The use of new blood thinners like dabigatran creates a significant problem if you suddenly acquire a situation that requires immediate reversing of the thinned blood. That is because they are not immediately reversible. Examples of those situations will be any brain bleed or any acute surgical conditions that need immediate surgery. Once on a blood thinner, there is a substantial risk that even a minor head trauma can lead to bleeding in the brain.
Acute Limb Ischemia
Acute Limb Ischemia (ALI) manifest as sudden onset of severe pain in the foot and legs. The involved extremity will feel cold and look pale. This review article in Scientifica describes in detail the different mechanisms of clot formation.
Volume 2012, Article ID 525374
The combination of high blood sugar, high triglycerides, inflammation, and obesity leads to problems in the lining of the blood vessels that leads to high blood pressure, more inflammation that makes the blood clot easier than usual.
A diagnosis of any disease related to the Metabolic Syndrome should prompt an investigation if you are at risk of developing ischemic heart disease or strokes.
Talk to your doctor if there is a need to do a fasting blood sugar, serum triglyceride, and HDL level checked to screen for MetS. Check your blood pressure and measure your waistline.
Read about intermittent fasting and start resistance exercises with or without the MetS. The best interventions against MetS.
Image Credits:
DVT By James Heilman, MD – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=9444797
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