Published: April 14, 2025
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Why anticoagulation in DVT, PE and Antiplatelets in myocardial infarction!! Red thrombus vs White thrombus! 1. DVT (Deep Vein Thrombosis) 》Pathophysiology: DVT occurs in the venous system, where stasis of blood, hypercoagulability, and endothelial injury (Virchow's triad) lead to clot formation. 》Clot Composition: Venous thrombi are fibrin-rich and contain lots of red blood cells and fewer platelets. These are sometimes called "red clots." 》Treatment Rationale: Since the clot is largely fibrin-based, anticoagulants like heparin, warfarin, or DOACs (e.g., apixaban, rivaroxaban) are effective—they target the coagulation cascade and prevent fibrin formation. 2. Myocardial Infarction (MI) 》Pathophysiology: MI is often due to rupture of an atherosclerotic plaque in a coronary artery, which triggers platelet activation and aggregation. 》Clot Composition: Arterial thrombi are platelet-rich, also called "white clots," formed under high shear stress. 》Treatment Rationale: Antiplatelet agents like aspirin (inhibits COX-1, reducing thromboxane A2) and P2Y12 inhibitors (e.g., clopidogrel, ticagrelor) are key to prevent platelet aggregation and subsequent occlusion of the coronary artery.

Image in tweet by Ahmed Ata

Simple Summary: DVT = venous = fibrin-rich clots → anticoagulants MI = arterial = platelet-rich clots → antiplatelets

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