According to a December 2023 report by Metro Express, Sir Run Run Shaw Hospital, affiliated to Zhejiang University School of Medicine, received a 72-year-old patient and had a blood clot of nearly 40 centimeters removed from her right leg.
Screenshot of the doctor's circle of friends. Map of the City Express
The old man had sudden pain in his right leg for 3 days, the pain was obvious, and the symptoms appeared without warning, from everything was normal to unable to walk, there was no transition in between.
After examination, the doctor found that the skin temperature of the old man's right lower limb was cold, and the right dorsal foot artery did not feel a pulse. The toes are pale and bloodless, and the toes are slightly purple, which is a sign of imminent necrosis of the limbs. Doctors consider that the patient is older, has sudden pain in one leg and is unable to walk, and atrial fibrillation, which may be thromboembolism, but this is true upon examination.
"Now everyone pays more attention to health, and it has been a long time since a blood clot has been removed for such a long time. Zhu Yuefeng, deputy director of the Vascular Surgery Center of Sir Run Shaw Hospital of Zhejiang University and director of the Department of Vascular Surgery of the Fourth Hospital of Zhejiang University, said that generally speaking, the early stage of the elderly is a small blood clot that falls from the heart, about 1-3 cm, and falls to the arteries of the lower limbs to cause blood vessel blockage, and within these 3 days, a new thrombus is formed in the arterial blood vessels that have been blocked for a long time, so the thrombus removed is 30-40 cm long. ①
There are 4 parts of the body that are most susceptible to blood clots
Ma Wentao, deputy chief physician of the Vascular Center of Fuwai Hospital of the Chinese Academy of Medical Sciences, published an article on the official account of "Fuwai Says Heart" in 2021 that theoretically, blood clots can occur anywhere in the arterial and venous systems.
There are 3 major thrombotic diseases in clinical practice:
Heart: myocardial infarction
Brain: Ischemic stroke (cerebral infarction)
Legs, lungs: venous thromboembolism
These three diseases have a high incidence and are very harmful. Of course, blood clots can also develop elsewhere. For example, the arteries in the intestines, the renal arteries, etc., but the relative incidence is low.
Myocardial infarction and cerebral infarction are familiar to everyone, and they are thrombosis that occurs in the arterial system. Venous thromboembolism includes deep vein thrombosis and pulmonary embolism of the lower extremities, which are blood clots that occur in the venous system. ②
Photo by Gong Jing
Pay attention to the 4 major signs that a blood vessel is blocked
1. Blockage of blood vessels in the heart: chest pain, back pain, etc
Luo Min, chief physician of the Pain Department of China-Japan Friendship Hospital of Jilin University, introduced in an article published in the People's Daily Health Account "Cardiovascular and Cerebrovascular Luo Min Doctor" in 2022 that heart vascular blockage refers to coronary heart disease. The typical symptom is chest pain, with stable angina being the most common and clinically known as exertional angina. Patients will increase the amount of activity (exercise, exertion), so that the heart accelerates, myocardial consumption, but due to the blockage of blood vessels, the blood supply can no longer meet the increased consumption, this situation of unstable supply and demand is stable angina.
In these patients, the chest pain will be relieved by stopping activities and getting enough rest, and it will not last too long (if it is more than 20 minutes and a myocardial infarction is suspected, call the 120 emergency number immediately).
However, it does not mean that the patient only has chest pain symptoms, the patient's discomfort symptoms are radiation, and pain in the front chest, back, left shoulder, left arm, and jaw teeth are all possible complications that require further diagnosis. ③
2. Cerebral vascular blockage: dizziness, headache, etc
In 2022, Dr. Luo Min published an article on the People's Daily Health Account "Cardiovascular and Cerebrovascular Doctor Luo Min", and said that patients with cerebral infarction will have corresponding manifestations in the early stage, such as dizziness, headache, drowsiness and fatigue, frequent blackness, stepping on cotton, transient aphasia, memory loss, blurred vision, etc. ③
3. Blockage of blood vessels in the lower limbs: unilateral leg swelling, etc
In an interview with Metropolis Express, Dr. Zhu Yuefeng reminded that if there is sudden unilateral limb pain or swelling (pain is more common in arterial thromboembolism, swelling is more common in venous thrombosis), go to the hospital for examination as soon as possible;
If you find intermittent claudication, such as walking 200 meters calf pain and soreness, you can walk after resting, and you must stop to rest after walking, so the cycle repeats, often indicating that the arteries of the lower limbs are narrowed and the blood supply to the legs is insufficient, even if it is not painful, it is recommended to check to determine the cause. ③
4. Blockage of blood vessels in the lungs: chest tightness and swollen legs, etc
Pulmonary embolism is a venous disease that occurs when blood in tissues is on its way back to the heart. Mi Yuhong, director of the Emergency and Critical Care Center of Beijing Anzhen Hospital, introduced in the live broadcast program of "People's Famous Doctor" in 2021 that the symptoms of pulmonary embolism are generally atypical. For example, chest tightness, dyspnea, transient syncope, these symptoms can also appear in myocardial infarction, coronary heart disease, pleurisy, epilepsy and other diseases.
If you have dyspnea after exercise that is relieved by sitting or lying down, if you suddenly lose consciousness when you walk and pass out but can wake up on your own, if you have chest pain that you breathe but when you hold your breath, if you have asymmetrical edema in both lower extremities with a difference of more than 2 cm in leg circumference, and if the echocardiogram clearly suggests pulmonary hypertension of unknown cause, you need to be alert and go to the hospital as soon as possible to assess the risk of pulmonary embolism or screen for other conditions with similar symptoms. ④
Prevent blood vessel blockage, stick to 5 things
1. Exercise must be insisted on, which can delay the progression of arteriosclerosis
Wang Qi, deputy chief physician of the Department of Cardiovascular Medicine of the Sixth Medical Center of the PLA General Hospital, issued a reminder in 2023 that proper exercise is essential for vascular maintenance, and exercise can increase cardiovascular reserve capacity, alleviate sympathetic nerve overexcitation, and delay the progression of arteriosclerosis. Depending on personal preference, age and cardiovascular ability, you can choose running, swimming, cycling, racket swinging, etc. Exercise at least 3~4 times a week, for more than 30 minutes each time. ⑤
2. Fruits, vegetables, and whole grains must be eaten more, which is beneficial to vascular health
In November 2021, an analysis conducted by academics from the First Affiliated Hospital of Xi'an Jiaotong University using data on the global burden of disease showed that unhealthy diets lead to 36.9% of cardiovascular deaths worldwide. Among them, the most influential is the "five less and one more" diet:
Eat less whole grains (19.2% attribution score)
High salinity (17.1%)
Eat less fruit (13.5%)
Eat less nuts and seeds (13%)
Eat less vegetables (9.7%)
Eat seafood with low omega-3 fatty acids (9.6%) (6)
It is recommended that there are vegetables in the meal, ensure that the daily intake of no less than 300 grams of fresh vegetables, dark vegetables should account for 1/2, 200 grams ~ 350 grams of fresh fruits per day, fruit juice can not replace fresh fruits. In addition, choose more whole grains in your diet, including millet, corn, oats, buckwheat, whole wheat, etc.
3. Be sure to have regular physical examinations and control the "three highs"
Have regular check-ups to understand your indicators. For example, adults between the ages of 20 and 40 should have their blood lipids measured at least once every 5 years. Men over the age of 40 and postmenopausal women are tested annually for lipid status.
People with high blood pressure, diabetes or abnormal blood sugar, as well as people who are obese, are at high risk of atherosclerosis. It is necessary to actively and reasonably control blood pressure, blood sugar, and blood lipids. ⑦
4. You can drink a few sips of water in the morning before going to bed
You can drink a glass of warm boiled water in the morning, about 200~300ml, which helps to maintain smooth blood flow and prevent thrombosis.
In addition, Xiao Hui, an attending physician in the Department of Neurology of Lianyungang Hospital of Traditional Chinese Medicine in Jiangsu Province, pointed out in an article in Health Times in 2016 that the human body sweats when it is asleep, resulting in a decrease in the water in the blood and a higher viscosity of the blood. Drinking 200 ml of water in the evening can reduce the blood viscosity in the morning. ⑧
5. For obese people to lose weight, their stomachs should not be too big
Metabolic syndrome, represented by abdominal obesity, is easy to increase the cardiovascular burden, causing a series of problems such as hypertension, hyperlipidemia, and hyperglycemia, leading to early arteriosclerosis. Weight loss is an effective means of circumventing this risk factor. ⑤
It is recommended that the waist circumference should be at least 90 cm < for men and 85 cm < for women.
This article is synthesized from:
(1)2023-12-17 Metro Express "Nearly 40 cm!"
(2)2021-02-08 Fuwai said the heart "Where is the blood clot easy to grow?"
(3)2022-07-20 People's Daily Health Account "Cardiovascular and Cerebrovascular Luo Min Doctor" "Vascular blockage needs to be distinguished from different parts, and the manifestations are different, and it needs to be treated as soon as possible, otherwise it can be fatal"
(4)2021-07-30 Health Times "Beware of Fatal Pulmonary Embolism"
(5)2023-05-28Public Health Magazine "Do these things well, blood vessels age slowly"
⑥Dong C, Bu X, Liu J, et al. Cardiovascular disease burden attributable to dietary risk factors from 1990 to 2019: A systematic analysis of the Global Burden of Disease study. Nutr Metab Cardiovasc Dis. 2021 Nov 29:S0939-4753(21)00552-4.
(7) Chinese Journal of Circulation,2023,38(3):237-271.
(8)2016-07-08Health Times Cardiovascular and Cerebrovascular Edition "Drink a Cup of Life-Saving Water Before Bedtime"
Source: Health Times