The main target of anticoagulant treatment is to avoid the creation of new thrombi and, at the same time, ensuring that the risk of bleeding does not increase
The treatment of thrombosis does not differ from that of pulmonary embolism, since both are manifestations of the same disease, VTE. An anticoagulant treatment for a minimum of three months is the rule.
We treat patients with VTE by administering anticoagulant drugs. These are drugs make blood thinner, thus the thrombi stop growing and detaching (if they break loose, pulmonary embolism will occur). With this treatment the thrombi slowly harden, get smaller, retract and become small scars.
Yet the thrombus is not always removed completely. What tends to happen is that it reduces in size and it gradually heals, so the vein where it formed or the pulmonary artery where it was located, eventually recovers nearly to its usual flow.
This is how anticoagulant treatment works
Anticoagulants allow the blood clot to stabilize and prevent the appearance of embolisms in the lung, but at the same token, this can also cause bleeding.
When doctors prescribe anticoagulant treatments, we try to minimize the risk of the thrombus increasing or breaking loose (and traveling to the lung) but at the same time, making sure that the risk of bleeding does not increase much. Sometimes it is very difficult to achieve such a balance.
Hemorrhage is the weak spot of anticoagulant therapy, this is why, in everyday tasks like shaving or brushing our teeth we bleed, and menstrual bleeding may be heavier if we take anticoagulants.
We can also bleed from small blows or cuts. Therefore we recommend patients to refrain from doing contact sports, such as football, rugby, mountain biking, skiing, while on anticoagulant therapy. A blow, that otherwise would only cause a bruise with no greater consequence, in a patient taking anticoagulants could become a serious hemorrhage. We furthermore advise you to be careful to not cut or prick yourself (in the kitchen, at work…).
In order to get the right dose of anticoagulants, it is necessary to see your the doctor and to follow their recommendations.
Both the diagnosis of TVE and the beginning of the treatment are done in a hospital. At first, the doctor administers heparin injections, but when the patient goes home, these injections are replaced with tablets: which are antivitamin K tablets, the best known being acenocoumarol (commercialized as Sintrom®).
Furthermore, recently we have also prescribed new oral anticoagulants, but only in countries where their use is approved and funded by the public health system .
How important is to take the treatment every time at the same hour?
You don’t need to set your alarm to take it at the exact time, but if you do it regularly at the same time, you won’t forget.
I take my treatment every day at the same time, but today I forgot it. Can I take double the dose tomorrow instead?
Most definitely not. Tomorrow you should take your usual dose. Try not to forget again, but never take more than the normal dose.
Some mornings, when brushing my teeth, I feel the taste of blood in my mouth and when spitting, the water is red. Should I tell my doctor?
If you are on anticoagulant treatment, it is something completely normal. It shows that it is being effective. A different thing would be if you were bleeding abundantly. Then, you should go to Emergencies Department.
Do you have questions?
If there are any aspects of thrombosis and/or pulmonary embolism that you are not sure about, you can contact us, and our specialists will answer you shortly. This cannot replace the visit to your doctor