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Are you at risk of blood clots?

By LAI S. REYES, The Philippine STAR Published Sep 28, 2021 5:00 am Updated Oct 01, 2021 7:38 am

Ramonito Saturno, an overseas Filipino worker in Saudi Arabia, was on board a commercial flight — from Jeddah to the Philippines — when he felt dizzy, restless, and disoriented just when the plane was about to land in NAIA.

“I thought I was just so excited to see my family again,” he shares. But the lady passenger beside Saturno suspected that something was wrong with him. She didn’t think twice and informed one of the flight attendants that Saturno needed medical attention.

As soon as the plane landed, Saturno was brought to the airport clinic for first aid, but was soon rushed to the ER of a private hospital. Saturno had suffered an ischemic stroke. A major operation was necessary to be able to save his life.

Ramonito Saturno had an ischemic stroke in 2019. He had to undergo a major brain surgery to survive.

What was supposed to be a happy family reunion turned into a nightmare for the Saturnos.

It could happen to you, too!

Stroke is one of the life-threatening health conditions triggered by thrombosis (blood clots) and atrial fibrillation (AF). Thrombosis, or blood clotting, is a normal body function to prevent excessive bleeding due to a ruptured vein.

  Stroke is one of the life-threatening health conditions triggered by thrombosis. 

"This happens when platelets mix with other blood components to form fibrin which coagulates blood to form a clot that covers the area of a ruptured atherosclerotic plaque” explains Dr. Johnny Lokin, president of the Stroke Society of the Philippines, during a virtual media forum on the dangers of blood clots.

The forum, presented by Menarini Asia-Pac, was held in observance of the Atrial Fibrillation Awareness Month this September. This effort is in line with the company’s initiative to raise awareness among people who are affected by blood clots or who are at increased risk for it.

 Dr. Marcellus Ramirez, secretary of the Philippine Heart Rhythm Society

However, there are patients who suffer from irregular heart movements that could abnormally cause clotting and could also lead to fatal conditions like stroke. These types of clots can travel to important organs and block the normal circulatory flow thus, disrupting their functions.

This moving blood clot is called an embolism that, if left undetected, could lead to death, warns Dr. Ramirez.

According to Dr. Ramirez, a patient can frequently develop blood clots if they are of old age, pregnant, obese, or smoking.

Atrial fibrillation is a disorder of the electrical system of the heart.

Thrombosis and atrial fibrillation are two factors to be considered to detect and prevent the risk of stroke happening to a patient, he adds. Atrial fibrillation is a disorder of the electrical system of the heart.

“It is characterized by very irregular heartbeats,” Dr. Ramirez explains. “And it’s the most common heart rhythm disorder.”

Adherence to medication is a key part of health care and affects all areas. Apart from compliance to medication, it involves following a recommended diet or implementing lifestyle changes that go along with medical advice.

A normal heart beats at a rate of 60 to 100 beats per minute to keep the heart pumping and ensure a continuous blood flow to the different organs of the body.

“The heart is able to do this because of the existence of an electrical system that keeps the heart in sync,” he adds. “So when there’s a problem with the electrical system, it can lead to atrial fibrillation. It can lead to life-threatening complications.”

And just like hypertension, which is a silent killer, most people suffering from atrial fibrillation don’t know they have it until it’s too late.

  Having blood pressure measures consistently above normal may result in a diagnosis of hypertension.

Research shows that between three to six percent of our population will have atrial fibrillation. The incidence goes higher as one grows older. In patients 65 years old and older, the prevalence is six percent, but for patients 20 years old and above, it’s about three percent.

“That’s why it’s important that once you reached the age of 65, you should get screened for atrial fibrillation by ECG or just a pulse check. Atrial fibrillation is like COVID-19. Some patients are asymptomatic,” says Dr. Ramirez.

Atrial fibrillation can also happen to those who have pre-existing heart, kidney or lung diseases, diabetes and high-blood pressure. Thyroid problems, sleep apnea, and metabolic syndrome can also cause atrial fibrillation.

The dangers of AF-related stroke

According to the Department of Health, and the Food and Nutrition Research Institute, atrial fibrillation puts a patient at a higher risk for a stroke. Since clots can happen to people suffering from AF, the deposits can sometimes reach the brain. That is why AF puts them at three to five times higher risk for getting a stroke.

Dr. Lokin discussed how clots can stop the blood flow to your brain and possibly cause a stroke.

 Dr. Johnny Lokin, president of the Stroke Society of the Philippines

If you look at stroke in general, all over the world, around 16 to 17 million people will have their first stroke at any given time, shares Dr. Lokin. In the Philippines, from 2010 to 2015, stroke is the third leading cause of death in the Philippines, next to heart disease and cancer.

Atrial fibrillation creates thrombosis that is pumped to the brain, blocking major arteries that carry oxygenated blood, which is crucial for brain function.

It is estimated that one-fourth of all strokes after the age of 40 are caused by AF. This condition is called ischemic stroke,’” explains Dr. Lokin.

Thrombotic stroke (stroke via blood clotting), on the other hand, would manifest in one or more mini-strokes, called transient ischemic attacks (TIAs).

 A regular pulse check can save you from the life-threatening complications of arterial fibrillation.

TIAs may last for a few minutes or up to 24 hours, and are often a warning sign that a stroke may occur. Despite this, AF-caused strokes can be prevented by taking anticoagulant (blood-thinning) medication, notes Dr. Lokin.

How to prevent stroke with medication

According to the National Stroke Association, thrombotic stroke is preventable through medication to manage blood clotting.

There are two ways to prevent the risk of getting a stroke: through medication adherence and compliance. Medication adherence, or taking medications correctly as prescribed by the doctor, is an integral aspect of blood clot management that many patients usually take for granted. But effective management of blood clots depends on patients’ self-care.

 Taking medications as prescribed by the doctor is an integral aspect of blood clot management.

Adherence to medication is a key part of health care and affects all areas. Apart from compliance to medication, it involves following a recommended diet or implementing lifestyle changes that go along with medical advice.

“Adherence to maintenance medication is a life-saving way as physicians, pharmacists, and nurses ensure that the patient has a full prescription of their needed anticoagulants and dutifully takes them on time,” advises Dr. Ramirez.