Bloody Minded Episode 63 - Virchow’s Revenge | Introduction to Venous Thromboembolism
Oct 7, 2025
Explore the fascinating world of venous thromboembolism as hosts dive into clots, clotting processes, and risk factors. Discover the intriguing history behind Virchow's triad and how it influences clinical assessments. Learn the key differences between arterial and venous clots, along with practical categorization of VTE risk factors. The discussion also covers effective management strategies, including anticoagulation choices and the implications of thrombosis history. Embark on this riveting journey through the pathways of clotting and care!
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Hemostasis Versus Thrombosis
- Hemostasis stops bleeding via vessel spasm, platelet plug formation, and fibrin reinforcement.
- Thrombosis is pathological clotting inside a vessel distinct from normal hemostasis.
Cascade To Fibrin
- Making fibrin requires generating lots of thrombin from prothrombin via prothrombinase (factor V + factor Xa).
- Factor Xa arises from either factor VIII/IX (intrinsic) or factor VII + tissue factor (extrinsic).
Virchow’s Historical Triad
- Rudolf Virchow described clot propagation and embolic risk in the 1800s and later framed the triad for thrombosis.
- The historic papers evolved into the triad: stasis, hypercoagulability, and endothelial damage.