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Welcome to Thrombophysiology

The Logical Study of Blood clots


by Dr Bode

 

Do you ever lie awake at night and wonder what makes the heart flip and flop like a fish out of water? Suddenly the heart flutters like a humming bird and then slows down with powerful pounding palpitations that cause hot flashes or night sweats.

Patients with fast fluttering pulses followed by slow strong palpitations frequently develop mysterious brain fog, confusion, weakness, and light-headed dizzy spells.

There is no simple explanation why the heart suddenly beats fast or slow; and not much really matters unless it changes our financial condition or romantic relationships. No one cares too much about the tachy-brady syndrome until they end up in the ICU with a fast / slow heart rate following a long night of drinking and dancing coupled with lack of sleep.

This website presents a new theory that venous blood clots migrate into the heart and interfere with blood flow through the valves. Clots in the valves change the heart rhythm pattern and causes palpitations. Moreover, venous thromboembolism (VTE) in the pulmonary artery squeeze the esophagus, which causes nausea, burping and difficulty swallowing. Burping (thrombo-ructus) while sleeping causes gastroesophageal reflux disease (GERD).

 

 

 DVT and Pulmonary Embolism

In 2005 Dr Bode became sick with a sore restless leg following hernia surgery. A CT scan revealed a blood clot inside the vein beneath the surgical site, and he took blood thinners to dissolve the clot. Later, he used a compression sleeve to squeeze his sore leg because gentle compression eliminates blood clots and prevents the formation of new ones.

Leg compression stimulated palpitations, arrhythmias, desaturations, and burping spells. Dr Bode heard heart murmurs with his stethoscope as he felt flip-flop palpitations inside his chest. Turning off the leg squeezer stopped the palpitations and murmurs.Thus, it was easy to 'see' that leg compression squeezed tiny slippery clots into the heart, where they caused murmurs and palpitations as they moved through the the heart valves. Moreover, clots inside the pulmonary artery pulsated against the esophagus during the heartbeat, which caused nausea and stimulated burping.

This website outlines the life cycle of venous blood clots and explains different problems caused by slippery purple clots as they form inside muscle, migrate through the heart, and stop in the lungs.. 

Thrombophysiology: the logical study of blood clots

Dr Rudolf Virchow, a German physician, discovered that blood clots in the lungs were the same as blood clots in the legs. He theorized that clots formed in the legs and that pieces of clot from the legs broke loose and migrated through the heart into the lungs. Virchow called migrating venous clots embolia.

Virchow noticed that stasis, trauma, and hypercoagulability led to the formation of venous clots.

Life Cycle of Venous Blood Clots

The life cycle of blood clots begins with hemostasis, altered metabolism, and the formation of thrombus called deep venous thromboses (DVT), which is the source of blood clots that migrate into the heart and stop inside the lungs.

After injury and DVT formation inside the legs, muscular contractions release pieces of DVT (blood clot), which migrate out of sore legs during walking or exercise. Migrating clots are venous thromboemboli (VTE), which move into the heart.

Some VTE pass through a congenital hole inside the heart between the atria, and become paradoxical embolim (PDE). PDE flow into the arteries of the body and cause trouble.

However, most VTE migrate through the heart and pass into the lungs where they stop in alveoli. Migrating clots that stop in the lungs are pulmonary emboli (PE).

Pathophysiology of DVT, PDE, VTE, and PE

1. DVT (deep venous thrombosis): cause sore, swollen, weak, warm, and red muscles.

2. PDE (paradoxical emoblism) = VTE migrate through PFO into body and cause ischemia / infarction

3. VTE in the heart (Thrombodextracardia)

  • VTE in the tricuspid valve causes tachycardia with fluttering jugular pulsations
  • VTE in the pulmonary valve causes bradycardia with flip-flop palpitations 
  • VTE in the pulmonary artery causes thrombo ructus, which leads to  GERD.

4. PE in the lungs cause congestion, wheezing, stop oxygen absorption, prevent exhalation of warm moist vapor full of carbon dioxide

Skipped Heartbeats: pulsus interruptus

It is theorized that a semisolid VTE shaped like a torpedo and about the size of a small golf pencil enters the pulmonary valve of the right ventricle. This decreases blood flow out of the right ventricle at the and causes an ECG pattern called bigeminy.

First, as the clot goes through the pulmonary valve, it reduces blood flow out of the right ventricle which causes a premature rise of pressure inside the ventricle, which stimulates a protective premature right ventricular contraction (PVC).

The premature contraction causes the valve to close and grip the nose of the clot as the right ventricle develops an isometric rotating contraction that ruptures the neck of the clot sack. This ruptures the neck of the clot, which releases sticky liquid detritus and decompresses the clot, which reopens blood flow through the pulmonary valve, which allows a normal sinus rhythm (NSR). The heartbeat following PVC pumps extra blood with clot sack and detritus into the pulmonary artery.

Next, the trailing part of the elongated golf pencil shaped clot re-obstructs the valve, which causes a second PVC. The second PVC causes the valve to grip the middle part of the clot, which causes another rotating isometric contraction which extends the rupture of the clot sack towards its tail. This releases more liquid detritus, which decompresses the clot and reopens the valve.

A second strong normal sinus rhythm heartbeat ( NSR) pumps extra blood plus the empty clot sac and detritus into the pulmonary artery, which carries the material into the pulmonary artery and lungs.

The ECG pattern is NSR / PVC / NSR / PVC / NSR as the heart skips every other pulse during an ECG pattern called ventricular bigeminy. 

If you listen to the heart with a stethoscope during bigeminy, you can hear a soft variable systolic murmur at the pulmonary valve as the clot passes through the valve.

Detritus (liquid clot) is released from the semisolid clot as it migrates into pulmonary alveoli. Detritus congests the capillaries of the alveoli, which causes wheezing and difficulty breathing. Moreover, detritus in the alveoli temporarily stops the absorption of oxygen during inspiration and prevents the exhalation of warm moist vapor full of carbon dioxide during exhalation.

Detritus causes desaturation, hypercapnea (elevated carbon dioxide) with narcolepsy, and hyperthermia (fever). Detritus causes sweating during hot flashes from PMS (premenstrual syndrome) and detritus causes night sweats in patients with lymphoma.

During bigeminy, the heart flips and flops because the right ventricle enlarges during isodextro-volumetric contractions as the clot obstructs the right ventricular out flow tract (RVOT). The left ventricle partially decompresses by pumping out a small volume of blood. The heart "flips" to the left during PVC and flops back to the right after the clot ruptures and releases detritus, which restores blood flow out of the heart. This is followed by normal sinus rhythm (NSR), which pumps out the ruptured sac plus extra blood and the heart flops back to the right.

The heart repeats a "flip-flop" process during the second PVC, which is followed by a second normal sinus contraction (NSR). Powerful pounding sensations occur because the ventricle pumps with more force to expel clot, debris, and extra blood during NSR that follows PVC.

The pulse slows down as the heart skips every other pulse during ventricular bigeminy because the heart contracts isovolumetrically and stops pumping blood during pulsus interruptus.The pulse rate becomes half of the speed of the ECG rhythm during bigeminy. In other words, the pulse oximeter records a pulse deficit as the ECG records a non-perfusing PVC during pulsus interruptus.

Novel  ECG Interpretation: blood flow generates electricity

In 1903 Dr. Einthoven discovered that the heartbeat generates electricity.

Cardiac electrophysiologists explain that cardiac muscle cell depolarization and repolarization events generate the electric potentials of the electrocardiogram (ECG). However, there seems to be a fundamental misunderstanding of the ECG.

In 1977, Eugene Findl and Robert Kurtz published Electrokinetic Potentials in a Left Ventricle/Aorta Simulator. They constructed left ventricle/aorta simulators to evaluate the possibility of generatimg EKG like signals by electrokinetic methodology. According to Findl and Kurtz, "The simulators produced pulsed turbulent flows, simulating mammalian heart pumping conditions. EKG like signals were generated by the motion of the electrolyte through the simulators."

It makes more sense to explain the T wave of the ECG in terms of blood flow generated by the contractions of the aorta and pulmonary artery. In addition, the Q wave can be explained as the downward outward bulging of the conjoint ventricles at the start of systole. Finally, ectopic pacemaker "re-entry" circuits observed inside the left atrium during supraventricular tachycardia (SVT) or atrial fibrillation make more sense if retrograde blood flow into pulmonary veins generates "re-entry" circuits.

 

Blood flow from cardiac contractions generates three separate and distinct electrolyte motion potentials during the heartbeat, and these potentials are the P, QRS, and T waves of the ECG.

First, two atria contract together and generate P wave potentials caused by retrograde flow of blood from the right atrium into the jugular vein.

Next, two ventricles contract together and generate QRS wave potentials caused by blood flow from the left ventricle into the aorta plus blood flow from the right ventricle into the pulmonary artery.

Last, the aorta and pulmonary artery contract together and pump blood, which generates T wave potentials that are mainly caused by blood flow upwards towards the carotid arteries.

Thrombo Arrhythmias:

Blood clots alter blood flow through the heart valves, which alters ECG patterns because blood flow generates the ECG waves, and altering blood flow will change the wave patterns.

Blood clots in the tricuspid valve cause premature atrial contractions, atrial flutter, or atrial fibrillation.

Moreover, blood clots in the pulmonary valve cause premature ventricular contractions (PVCs). Blood clots cause a wide notched QRS as they pass through the pulmonary valve. 

Movever, PDE (paradoxical emoblism) into the RCA (right coronary artery) cause inferior MI (myocardial infarction) that weakens the apex of the conjoint ventricles. This causes a pathological downward outward bulging of the apex of the at the start of systole (takotsubo effect of the 'broken heart syndrome). The downward movement of blood during the start of  ventricular systole explains the Q waves of the QRS of the ECG caused by embolic myocardial infarction.

Finally, pulmonary valve VTE cause the long QT because blood flow out of the pulmonary artery is delayed, which delays and lengthens the T wave of the ECG.

Thrombo Theory Questions & Answers:

  • What makes the heart skip a beat? Pulmonary valve VTE causes PVC's with pulse deficits.
  • How does a solid blood clot (thrombus) cause the heart to skip a beat? It interferes with blood flow through the pulmonary valve, which triggers a protective contraction of the ventricle.
  • What causes blood to form clots? Abnormal metabolism produces acid, which denatures protein, which causes blood to coagulate.
  • Why does abnormal anaerobic (hypoxic) metabolism make lactic acid? Metabolism without oxygen produces metabolic acid.
  • Why does cancer cause clots? Dr Otto Warburg discovered that cancer cell glucose metabolism produced lactic acid, and metabolic acid causes blood clots.
  • Why do runners get clots and PVC's? Dr Otto Meyerhof discovered that anaerobic muscle metabolism produces lactic acid, which causes blood clots, PVCs and palpitations in runners.
  • How does lactic acid activate the blood clotting mechanism? Acid denatures blood proteins, which becomes like velcro. Sticky proteins coagulate with platelets and red cells to form clots.
  • What makes blood clots migrate (embolize) into heart valves? Exercise or walking breaks off pieces of DVT and squeezes them out of sore veins into the heart.
  • What happens to the heart rhythm as clots pass through different heart valves? VTE at the tricuspid valve causes tachcardia and VTE at the pulmonary valve cause bradycardia.
  • Do blood clots cause fluttering or flip flop palpitations? Yes.
  • Why do arrhythmias cause low blood pressure with lightheaded dizzy spells? VTE reduces the ejection fraction, which reduces blood pressure and causes lightheaded dizzy spells.
  • Does partly clotted blood called detritus interfere with breathing? Yes.
  • How do blood clots cause coughing, nausea, gagging and sneezing? VTE inside the pulmonary artery accumulate at the junction where the artery passes in front of the spine. The esophagus touches the back of the heart and pulsating VTE in the artery choke the esophagus causing difficulty swallowing or talking, coughing, gagging, nausea, and sneezing.
  • Do blood clots or detritus cause panic attacks or internal suffocation? Yes.
  • Do blood clots cause pulseless fainting? Yes.
  • How do blood clots cause epileptic seizures? VTE at the pulmonary artery stops the flow of blood into the brain and lungs, which triggers an anoxic convulsions.
  • Do blood clots cause sudden thrombocardiac arrest? Yes, VTE obstruct the pulmonary valve, which stops cardiac output.
  • How does CPR reanimate someone with cardiac arrest without defibrillation? CPR expels clots out of the obstructed valve, which reopens blood flow into the brain and lungs, which reverses acidosis and reanimates someone suffering from sudden thrombocardiac arrest. Early CPR prevents ventricular muscle dilation, which requires powerrful defibrillation to reverse.

Theory of Thrombo Associated Diseases:

  • Cancer → lactic acid → blood clots (Warburg effect)
  • Carbon monoxide poisoning: detritus causes night time hypoxemia → carboxyhemoglobinemia
  • Chronic Fatigue Syndrome
  • Congestive heart failure: right heart failure, valve malfunction, low ejection fraction
  • Exercise-induced asthma: pulmonary embolism (PE) of detritus
  • Fainting spells
  • Gastro esophageal reflux disease (GERD)
  • Infection: anaerobic germ metabolism muscle: glucose → lactic acid → blood clots
  • Injuries: foot, leg, knee, or hip injury → blood clots
  • Headaches: pulmonary detritus ↓ water exhalation → brain edema, headache
  • Insomnia: PE at tricuspid valve → thrombotachycardia → sleep arousal 
  • Macular degeneration: micro emboli
  • Malignant hyperthermia: PE → atelectasis, fever, VTE arrhythmias
  • Migraine headaches
  • Narcolepsy: PE detritus → ↓ exhalation of CO2 → hypercapnea → CO2 narcosis
  • Panic attacks: PE of detritus, desaturation, dyspnea
  • Peripheral neuropathy: venous vascular acidosis → neuropathy, restless leg
  • Pleurisy: PE into alveoli causes sharp ischemic pain
  • Pre-menstrual syndrome: PE of detritus, hot flashes, headache (edema), mild fever
  • Pyriformis syndrome: compartment syndrome, venous acidosis
  • Seizures: VTE at pulmonary valve, sudden hypoxia, convulsions perform CPR
  • Sick Sinus Syndrome: VTE at tricuspid and pulmonary valves
  • Sleep apnea: PE detritus → internal hypercapnea with central CNS depression, central apnea
  • Syncope: short runs of continuous skipped beats, VTE at pulmonary valve
  • Tinnitus: emboli of detritus into sensitive area of inner ear

Theory of Thrombo Symptoms

  • Anxiety, panic attacks
  • Brain Fog
  • Bradycardia
  • Choking
  • Coughing
  • Confusion
  • Depression
  • Dizzy spells
  • Dyspnea (short of breath)
  • Exercise-induced asthma
  • Fainting
  • Fatigue
  • Fear of sudden death
  • Fever: seizure fever, night sweats, hot flashes, malignant hyperthermia
  • Fluttering fast weak jugular palpitations, pulsus reversus
  • Flip-flop pounding slow strong palpitations
  • Gagging
  • Headaches
  • Hot flashes
  • Insomnia with fast racing heartbeats
  • Irregular pulse, pulsus erraticus
  • Irritability
  • Phlebitis
  • Premature beats
  • Light-headed sensations
  • Muscular dystrophy
  • Nausea
  • Night sweats
  • Palpitations
  • Panic Attacks
  • Racing heartbeat
  • Restless leg
  • Seizures / grand mal unconscious convulsions
  • Shortness of breath (dyspnea)
  • Skipped heartbeats
  • Sleep arousal
  • Slow pulse / flip-flop palpitations / skipped heartbeats
  • Sneezing
  • Sudden cardiac arrest syndromes
  • Sore legs
  • Tachycardia
  • Vertigo

Thrombo Diagnosis

  • History: fluttering / flip-flop palpitations, night sweats with racing heartbeats, insomnia, panic attacks with choking, coughing, sneezing with shortness of breath, chronic fatigue, chronic bronchitis, ‘flu’ syndrome, fast weak irregular heartbeat  / slow strong 'pounding' heartbeats, peripheral neuropathy
  • Physical Examination: slow strong ventricular heartbeats mixed with fast weak atrial heartbeats, soft musical grade I – II systolic murmur, mild fever
  • Pulse Oximetry: oxygen desaturation events, elevated peripheral carboxyhemoglobin in sore extremities with phlebitis & peripheral neuropathy
  • Electrocardiogram: premature atrial beats, atrial flutter / fibrillation, premature ventricular beats, tachy-brady / brady-tachy / sick sinus syndrome
  • Echocardiogram: pulmonary valve insufficiency / tricuspid valve regurgitation
  • Arterial Blood Gas (ABG): elevated carbon dioxide saturation (hypercapnea), low oxygen saturation, elevated carboxyhemoglobin
  • Capnography: end tidal expired carbon dioxide (ETCO2) decrease corresponds to oxygen desaturation events (SpO2)

Treatment / Prevention of Bloody Clots

  • Eight hours of rest / sleep every night (decreases metabolic acidosis)
  • Avoid excess drug and alcohol use
  • Maintain adequate water intake, avoid exercise-induced dehydration
  • Diet & Nutrition: control how much and what you eat
  • Moderate aerobic exercise: golf, sex, bowling, gardening, walking, yoga, tai chi
  • Sequential venous compression treats & prevents blood clots
  • Ultrasound: helps resolve inflammation and phlebitis
  • Vibration exercise oscillates bloody clots out of heart valves

What do doctors know about carboxyhemoglobin, the sick sinus syndrome or the long QT?

Thrombodextracardia is a new theory that explains how VTE interfere with blood flow at the triscupid and pulmonary valves, which causes the tachy-brady rhythm of the sick sinus syndrome.

Novel ECG Interpretation: Findl and Kurtz

Blood flow from cardiac contractions generates the electrokinetic potentials of the ECG. Because blood clots alter blood flow, which alters the ECG pattern, the ECG can diagnose blood clots in the heart valves. VTE in the tricuspid valve causes pulsus reversus, PAC, SVT, atrial flutter, and paradoxical atrial fibrillation; while VTE in the pulmonary valve causes PVC, pulsus interruptus, and the long QT.

Novel circulating pH Biomarker:

SpCO (carboxyhemoglobin) identifies extremities with acidosis, which causes DVT formation and peripheral neuropathy with restless leg syndrome.

Thrombo Future: The importance of pulse oximeter / ECG discoveries:

  • Thrombophysiology: hemostasis alters metabolism and produces hemoacidosis
  • Compartment syndrome acidosis causes hemothrombosis (DVT, VTE, potential PDE, & PE)
  • Carboxyhemoglobin locates acidosis and evaluates venous blood flow and neuropathy
  • The pulse oximeter SpCO evaluates DVT therapy
  • Compartment syndrome acidosis causes vascular neuropathy
  • SpCO is a circulating biomarker that evaluates vascular neuropathy and the restless leg syndrome
  • DVT, VTE, PDE, and PE have a life cycle filled with pathological events and altered vital signs
  • Muscle DVT cause inflammation
  • Cardiac VTE cause the sick sinus syndrome and GERD
  • PE of liquid detritus causes desaturation, hypercapnea, narcolepsy and more
  • The ECG can diagnose blood clots in the heart valves
  • VTE in the tricuspid valve cause PAC and pulsus reversus
  • VTE in the pulmonary valve cause PVC and pulsus interruptus
  • Cell phone apps evaluate PVCs and skipped heartbeats
  • Consecutive skipped beats cause fainting, convulsions, and sudden cardiac arrest
  • ECG apps can emit warning signals during consecutive PVC
  • Pulse oximeter cell phone apps can detect desaturation events that lead to narcolepsy
  • Cell phones can emit warning signals during desaturation events that predict narcolepsy
  • Cell phone can detect ECG VTE that cause skipped beats and emit warning signals
  • Cell phones can improve safety by emitting signals of impending fainting episodes
  • We can become happier as brain fog fades away
  • Thank you for your interest and find joy in your journey as you learn more about solid cardiac VTE that cause pulsus interruptus or liquid PE that cause desaturation with narcolepsy
 

 

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