“Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become overactive.

When injured, proteins in the blood that form blood clots go to injured site to help stop bleeding. If these proteins become abnormally active throughout the body, you could develop DIC. The underlying cause is usually due to inflammation, infection, or cancer.  DIC can also be caused in pregnancy.

In some cases of DIC, small blood clots form in the blood vessels. Some of these clots can clog the vessels and cut off the normal blood supply to organs such as the liver, brain, or kidneys. Lack of blood flow can damage and cause major injury to the organs.

In other cases of DIC, the clotting proteins in your blood are consumed. When this happens, you may have a high risk of serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts spontaneously (on its own). The disease can also cause your healthy red blood cells to fragment and break up when they travel through the small vessels that are filled with clots.”

Medline Plus (https://medlineplus.gov/ency/article/000573.htm)

Disseminated intravascular coagulation (DIC) is a rare and serious condition that disrupts your blood flow. It is a blood clotting disorder that can turn into uncontrollable bleeding. It is sometimes called consumption coagulopathy.

Disseminated intravascular coagulation (DIC) is a rare, life threatening condition. It’s also sometimes called consumption coagulopathy.

In the early stages of the condition, DIC causes your blood to clot excessively. As a result, blood clots may reduce blood flow and block blood from reaching bodily organs.

As the condition progresses, platelets and clotting factors — the substances in your blood responsible for forming clots — are used up. When this happens, you may begin to experience excessive bleeding.

DIC is a serious condition that can lead to death. If you have bleeding that won’t stop, go to an emergency room or call 911 for prompt medical treatment.

Etiology of DIC (There is more than one cause factor):

1-Acute obstetrical hemorrhage is one of the leading causes for DIC in pregnancy and is one of the most avoidable etiologies of maternal death.  Disseminated intravascular coagulation (DIC) is a rare, life threatening condition. It’s also sometimes called consumption coagulopathy.

2-Disseminated intravascular coagulation has been linked to certain medical treatments or conditions. Medical treatments that can cause DIC include:

• Blood transfusion reactions.
• Recent surgery or anesthesia.

3-Medical conditions that can cause DIC include:

• Cancer, especially certain types of leukemia.
• Pancreatitis.
• Blood infections.
• Liver disease.
• Severe tissue injury including burns and head injuries.
• Unformed blood vessels called hemangioma.

What can you do?

Unfortunately, that means there’s very little you can do to prevent DIC. What you can do is to talk to your healthcare provider about DIC so you know what changes in your body might be a sign of it.

If you have DIC, you’re probably already coping with serious medical conditions such as sepsis and cancer, or you’re recovering from serious injuries. Fortunately, early diagnosis and supportive treatment can help to stop the blood clotting or bleeding that DIC causes so that your healthcare providers can focus on treating your underlying illnesses or injuries.

How to manage disseminated intravascular coagulation (DIC)?

Being diagnosed with disseminated intravascular coagulation means you have another medical concern to manage as you continue the treatment and testing for the medical condition that caused your DIC. Here are some suggestions that might help:

• Take all medicines regularly, as your healthcare provider prescribes. Do not change the amount of your medicine or skip a dose unless they tell you to.
• Ask your provider before taking any over-the-counter products such as pain relievers, vitamins, supplements or herbal remedies.
• Talk with your provider about how often you should schedule office visits and blood tests to monitor the medications you’re taking.
• If you’re taking blood thinners, make sure all your providers know so they can adjust treatment accordingly.

DIC can have serious complications. You should go to the emergency room right away if you have:

• Heavy bleeding that you can’t control.
• Heart attack symptoms-chest pain/discomfort, sudden squeezing of the heart, headache, palpitations, dizziness, SOB or dyspnea,  pain down L arm, vision change-one or both eyes, loss of balance, sudden fatigue.
• Stroke symptom-difficulty speaking, change in mental status, sudden confusion, drooping of the mount on one side, one side of the body weak or paralyzed, difficulty eating, aspiration, difficulty walking or standing.

“Blood has a seemingly impossible job: It must flow continuously and smoothly throughout your body for an entire lifetime, but quickly shut off to prevent spills when you get a cut or injury.  Blood clots are healthy and lifesaving when they stop bleeding.  Platelets get “turned on” by triggers released when a blood vessel is damaged. They stick to the walls in the area and each other, changing shape to form a plug that fills in the broken part to stop blood from leaking out. Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured.”

WebM.D.

Why blood clotting is a vital important part of the bloodstream through platelets and how it works is what would we will review first to understand disseminated intra-vascular coagulopathy (DIC).  It is a vital important process of the platelets that make up part of our bloodstream cells that help prevent excessive bleeding or excessive hemorrhage.

In how clotting works is platelets, which is a type of blood cell, with plasma that is in our liguid part of blood work together to stop the bleeding by forming a clot over the injury (a bruise or cut in the skin) which stops the bleed.  Both veins and arteries transport our blood (both solids=cells) and the liguid (the plasma) that are read by out hematocrit and hemoglobin in a CBC=complete blood count which also tell the MD our reading of red/white blood cell counts with platelets.  Typically, your body will dissolve the clot after the injury has healed.  However, there are times clots form on the inside of our vessels (there are variables of why this would happen that are discussed later in this topic).  These situations can be dangerous and put the pt at risk for problems.  This needs to be diagnosed and given appropriate treatment by your doctor or MD specialist.

Clots can occur in our veins or arteries and can occur is various areas causing

1-DVT=Deep Vein Thrombosis

DVT commonly in our large veins that are commonly found in our lower extremities and less likely in our upper extremities or pelvic region or other areas where there are large veins. The problem (one the clot is wedged and stuck against the vessel) with this the clot blocks off circulation to the area below the clot to a percentage low to 100% blockage.  This is where in the skin there is pain to necrosis below the clot area (for this to happen it takes numerous hours-pain to days-changes in skin color or week or more-necrosis depending on the blockage).   The greater the blockage is the quicker the symptoms arise no matter where the clot is.  It is estimated that each year DVT affects as many as 900,000 people in the United States by the American Heart Association and kills up to 100,000 by the Centers for Control and Prevention (CDC).

-Paget-Schroetter Syndrome (PSS) – It’s a rare kind of DVT that typically happens to a young, healthy person who plays sports that use the upper arms a lot, like swimming and baseball. The vein can get squeezed by the muscles around it. This pressure, along with repeated movements, can cause a clot in your shoulder. Symptoms like swelling, chest pain, and a blue color to your skin may come on suddenly. PSS can be serious if it’s not treated right away.

2-Atrial Fibrillation

Another area where blood clotting can occur is in the heart.   We see commercials all the time about atrial fibrillation=irregular rhythm with the heart beat.  In the commercial its usual an add for a med called a anticoagulant that does the opposite of what platelets do=clotting to prevent this problem from happening in the heart which indirectly prevents clotting in all vessels as well.  The med thins the blood.   The major problem with this diagnosis, atrial fibrillation without being on a anticoagulant, is blood can pool in the heart causing a clot to form in the heart and at some point, especially when the rhythm is rapid and more irregular that usual=RVR-rapid ventricular rate over 100 beats per minute and usually over 130 to over 150, the clot can break off.

3-Heart Attack

Know this, more often than not, a broken piece of plaque within the arteries triggers the formation of a blood clot. This blood clot is the reason for a heart attack. As the blood clot potentially restricts the flow of blood and oxygen to the heart, depending on the severity, the heart attack can cause sudden death.

There are other areas where blood can form clots but not as common in what was mentioned above. Blood clots can arise anywhere in your body. They develop when blood thickens and clumps together. When a clot forms in a vein deep in the body, it’s called deep vein thrombosis. Deep vein blood clots typically occur in the lower leg or thigh.

The biggest consequence of any blood clot no matter where it is it can break off in time for many especially with a DVT or atrial fibrillation not on a anti-coagulant or anti-platelet like Coumadin, Eliquis, heparin, and lovenox to Plavix, Brilinta, Ticlid and Integrilin with other medications (listed commonly used in my nursing career).

When a clot breaks off it floats now in the bloodstream and can in time make it back to the heart putting the pt at risk for a heart attack, or now going to the lungs putting the pt at risk for a pulmonary embolism or now in circulation making it to the brain putting the pt at risk for a stroke!  Clots are common in making the strokes in what we call ischemic stroke and another name “silent stroke”.   Silent strokes are much more common than strokes that cause classic symptoms such as face drooping, arm weakness and speech difficulty and affect nearly 800,000 Americans each year. According to the statement, one in four people over 80 have one or more silent strokes.

“Asthma is a disease that affects your lungs. It causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing.  Asthma can be controlled by taking medicine and avoiding the triggers that can cause an attack. You must also remove the triggers in your environment that can make your asthma worse.  Since 1984, the Asthma and Allergy Foundation of America (AAFA) has declared May to be “National Asthma and Allergy Awareness Month.” It is a peak season for people with asthma and allergies, and a perfect time to educate patients, family, friends, co-workers, and others about these diseases.“.

Centers of Disease Control and Prevention – CDC

“Uncontrolled high blood pressure can lead to complications including: Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications. Aneurysm.”

MAYO CLINIC

High blood pressure in general can cause problems for you like:

1-Aneurysm. Over time, the constant pressure of blood moving through a weakened artery can cause a section of its wall to enlarge and form a bulge (aneurysm).  Aneurysms can occur anywhere but the body most common place is the abdominal aortic aneurysm.  The aorta is the largest blood vessel in the body. It begins at the left ventricle of the heart and travels down the abdomen where it splits off into both legs.  The abdomen gives the aneurysm plenty of room to grow before it bursts (if not diagnosed yet & treated via surgery), like in actor John Ritter’s case (he died of a ruptured aortic aneurysm).  Other areas of aneurysms seen are thoracic aortic aneurysms and cerebral aneurysms (in the brain).

2-Damaged and narrowed arteries.  High blood pressure can damage the cells of your arteries’ inner lining. When fats from your diet enter your bloodstream, they can collect in the damaged arteries. Eventually, your artery wall first is with the added force against it over time, this extra pressure can damage the arteries, making them more vulnerable to the narrowing and plaque buildup associated with arthero/arterio sclerosis.

High Blood Pressure most commonly impacts the following organs (remember their problem is lack of 02, nutrients, to the organ):

1-THE BRAIN:  Damage directly to the brain can cause many problems for that organ, including

• Transient ischemic attack (TIA). Sometimes called a ministroke, a TIA is a brief, temporary disruption of blood supply to your brain. Hardened arteries or blood clots caused by high blood pressure can cause TIA.  TIA is often a warning that you’re at risk of a full-blown stroke.  Most cases they are REVERSIBLE!
• Stroke. A stroke occurs when part of your brain is deprived of oxygen and nutrients, causing brain cells to die. Blood vessels damaged by high blood pressure can narrow, rupture or leak. High blood pressure can also cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke. Cat Scan the first test will show the bleed in the brain and ER will get pt to OR STAT if a candidate.
• Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the brain can also cause vascular dementia.
• Mild cognitive impairment. This condition is a transition stage between the changes in understanding and memory that generally come with aging and the more-serious problems caused by dementia. Studies suggest that high blood pressure can lead to mild cognitive impairment and definitely strokes can also but varied.

Your brain depends on a nourishing blood supply to function properly. High blood pressure can interfere with oxygen supply to brain tissue=LACK OF NUTRIENTS causing problems.

BRAIN DAMAGE not reversible completely or at all includes:

A-Ischemic Strokes

High blood pressure can also cause blood clots to form in the arteries leading to your brain  By narrowing of the arteries in the brain causes blockage of nutrients to an area of the brain.  The nutrients is oxygen to that area of the brain and without it the tissue dies causing the ischemic (meaning lack of 02) stroke.  This is the most common type of stroke. They occur when blood flow to an area of the brain is compromised by a blood clot or blockage. This leads to the death of brain cells and to brain damage.  If the brain damage is 100% reversible its cause is a transient ischemic attack (TIA).

B-Causes of Hemorrhagic Strokes

Most strokes occur due to a blockage of blood flow to a part of the brain, but approximately 13% of strokes occur due to bleeding in the brain.

2-THE HEART:  Damage directly on your heart can cause many problems for that organ, including:

A-Coronary artery disease. Arteries narrowed and damaged by high blood pressure have trouble supplying blood to your heart. When blood can’t flow freely to your heart, you can have chest pain (angina), irregular heart rhythms (arrhythmias) or a heart attack.

B-Enlarged left heart. High blood pressure forces your heart to work harder to pump blood to the rest of your body. This causes part of your heart (left ventricle) to thicken. A thickened left ventricle increases your risk of heart attack, heart failure and sudden cardiac death.

C-Heart failure. Over time, the strain on your heart caused by high blood pressure can cause the heart muscle to weaken and work less efficiently. Eventually, your overwhelmed heart begins to fail. Damage from heart attacks adds to this problem.

 A-Kidney Scarring:

This type of kidney damage occurs when tiny blood vessels within the kidney become scarred and unable to effectively filter fluid and waste from your blood.  Glomerulosclerosis can lead to kidney failure.

B-Kidney failure:

High blood pressure is one of the most common causes of kidney failure. Damaged blood vessels prevent kidneys from effectively filtering waste from your blood, allowing dangerous levels of fluid and waste to accumulate. You might ultimately require dialysis or kidney transplantation.

4-EYES:  Damage directly on your eyes can cause many problems for that organ, including:

High blood pressure can damage the tiny, delicate blood vessels that supply blood to your eyes, causing:

• Damage to your retina (retinopathy). Damage to the light-sensitive tissue at the back of your eye (retina) can lead to bleeding in the eye, blurred vision and complete loss of vision. You’re at an even greater risk if you have diabetes in addition to high blood pressure.
• Fluid buildup under the retina (choroidopathy). Choroidopathy can result in distorted vision or sometimes scarring that impairs vision.
• Nerve damage (optic neuropathy). Blocked blood flow can damage the optic nerve, leading to bleeding within your eye or vision loss.

5-Sexual dysfunction

The inability to have and maintain an erection (erectile dysfunction) becomes increasingly common in men as they reach age 50. But men with high blood pressure are even more likely to experience erectile dysfunction. That’s because limited blood flow caused by high blood pressure can block blood from flowing to your penis.

Women can also experience sexual dysfunction as a result of high blood pressure. Reduced blood flow to the vagina can lead to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm.

What your heart is doing what we call compensating and saving blood for the main organs including the brain, heart, kidneys, lungs to stay alive.  Areas not a priority are usually furthest away from the heart the feet, genitals, hands, etc…  So less blood the heart is sending their due to high blood pressure related to hypertension causing vessel narrowing to problems in the body.

High blood pressure emergencies:

High blood pressure is usually a chronic condition that gradually causes damage over the years. But sometimes blood pressure rises so quickly and severely that it becomes a medical emergency requiring immediate treatment, often with hospitalization.

In this situation occurs, know high blood pressure can cause:

• Memory loss, personality changes, trouble concentrating, irritability or progressive loss of consciousness
• Stroke
• Severe damage to your body’s main artery (aortic dissection)
• Chest pain
• Heart attack
• Sudden impaired pumping of the heart, leading to fluid backup in the lungs resulting in shortness of breath (pulmonary edema)
• Sudden loss of kidney function
• Complications in pregnancy (preeclampsia or eclampsia)
• Blindness

THE KEY IS PREVENTION!  So stay in your average healthy weight range, eat overall healthy foods, see your MD once or more a year for a physical (if under 50) or go to y0ur primary care doctor when he prescribes especially if you have a disease of some sort (Example Diabetes or HTN, ect..), stay active and don’t be inactive home especially during this COVID situation.

Another thing is simply to have your own BP machine at home so you can take it everyday and keep an eye on changes especially is your diagnosed, age, especially with the diagnosis hypertension and taking meds for it or diagnosed with cardiac disease!  You can stay on top of it this way with staying healthy and not unhealthy!

Always check with your doctor when to be seen if not sure, he or she would know best especially if he or she already knows your medical history!

“If left untreated, high blood pressure may lead to a heart attack, heart disease, heart failure, stroke, kidney damage and peripheral arterial disease, among other health problems. And, while patients with high blood pressure are not considered at high risk from COVID-19, the U.S. Centers for Disease Control and Prevention (CDC) points out that many patients with hypertension have other conditions, such as obesity, diabetes and heart conditions, that do put them at higher risk. The CDC recommends that patients with high blood pressure stick to their medication and treatment regimens. It’s vital to get your blood pressure checked regularly and to know the signs of high blood pressure: Take steps to improve their overall health and help manage their blood pressure.  Some patients may not feel any ill effects from hypertension, which is why it is sometimes called the “silent killer.” .

Cancer Treatments of America

“High blood pressure (HBP or hypertension) is when your blood pressure, the force of your blood pushing against the walls of your blood vessels, is consistently too high.  You have a top and bottom number making the systolic B/P =your pressure when the heart is at work and the bottom number is the heart pressure at rest.  In order to survive and function properly, your tissues and organs need the oxygenated blood that your circulatory system carries throughout the body. When the heart beats, it creates pressure that pushes blood through a network of tube-shaped blood vessels, which include arteries, veins and capillaries. This pressure — blood pressure — is the result of two forces: The first force (systolic pressure) occurs as blood pumps out of the heart and into the arteries that are part of the circulatory system. The second force (diastolic pressure) is created as the heart rests between heart beats.”.

American Heart Association

“While there is no cure yet for cystic fibrosis (CF), people with CF are living longer, healthier lives than ever before. In fact, prior to the 1950s, children with the most common and most serious forms of cystic fibrosis rarely lived past age 5.  Today, babies born with CF are expected to live into their mid-40s and beyond. Life expectancy has improved so dramatically that there are now more adults with cystic fibrosis than children.  There are people living past their 70’s.”

CF – cysticfibrosis.org