Varicose veins can cause changes in what component of Virchow’s triad?
A. Blood coagulability
B. Vessel walls
C. Blood flow
D. Blood viscosity
Correct Answer: C. Blood flow
Venous stasis is more likely to occur in patients with atrial fibrillation, valvular heart disease: prolonged immobility such as bedridden patients or prolonged travel, surgery, and trauma. Exposure to cell proteins triggers anticoagulant pathways on the surface of endothelial cells. The thinking is that as blood flow slows through vascular beds, flow reduces, and the natural anticoagulant properties from interaction with surface proteins are affected, resulting in thrombi production.
Option A: Hypercoagulability can occur due to a variety of clinical statuses such as pregnancy, use of oral contraceptive medications, cancer, chemotherapy drugs, and inherited thrombophilias. Thrombophilias can include disease states such as protein C deficiency, protein S deficiency, antithrombin deficiency, hyperhomocysteinemia and homocystinuria, and antiphospholipid syndrome.
Option B: Damage to the endothelial wall of a vessel alters the dynamics of blood flow. Endothelial disturbance can result from insults such as smoking, chronically elevated blood pressure, and atherosclerotic disease secondary to hyperlipidemia. When an insult to the wall occurs, flow disruption or “turbulence” occurs.
Option D: Turbulent flow within a vessel occurs when the rate of blood flow becomes too rapid, or blood flow passes over an affected surface; this creates disordered flow and eddy currents, increasing the friction of flow within a vessel.
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