Each year, blood clots inside the heart account for 20 percent of ischemic strokes--or strokes due to lack of blood to the brain, according to Loyola University professor of neurology Michael J. Schneck, M.D. In medical terms, a clot originating from the heart is called cardiogenic embolism. A heart condition known as atrial fibrillation is commonly associated with this type of clot formation. Cardiogenic embolisms can appear after a heart attack, during heart failure and as a result of natural or artificial heart valve disorders. Four blood-thinning drugs are commonly used to treat these clots.
Warfarin
Warfarin is more commonly known by its brand name Coumadin and is a popular blood-thinning drug for treating most sources of heart-borne clots. Also an anticoagulant, warfarin works to reduce blood clot formation in the body by lowering levels of vitamin K, which is a necessary component in the clotting process. It minimizes the risk of a heart clot breaking off and traveling to the brain. Patients taking warfarin require close monitoring to ensure the anti-clotting mechanism is not influenced by diet or other medications, both of which can cause fluctuations of vitamin K in the body. Administered orally, this drug comes in 1 mg, 2 mg, 2.5 mg, 5 mg, 7.5 mg and 10 mg tablets. Side effects of warfarin include increased risk of internal and external bleeding and gangrene.
Heparin
Heparin is a blood thinner and anticoagulant used for preventing growth of new or existing cardiogenic clots. Although this drug is not capable of directly removing clots that have already formed, it does effectively increase the body's natural clot-dissolving abilities. Heparin works by interfering with the clot formation process. Heparin is one of the oldest clinical drugs in use today, and it is administered in the form of injection or intravenous drip. Heparin works faster than oral blood thinners and this is why it is given before warfarin in emergency situations for treating cardiogenic clots. Similar to warfarin, heparin increases risk of developing severe bleeding, hemorrhaging and bruising.
Aspirin and Clopidogrel
Aspirin and clopidogrel are blood thinners belonging to a different class of drug called antiplatelet agents. Both medications are usually administered together after a heart attack to prevent cardiogenic embolisms. These antiplatelet drugs work by reducing the amount of platelets available in the clotting process. Platelets are special cells in the blood responsible for clot formation. While warfarin and heparin are considered primary measures in treating cardiogenic embolisms, aspirin and clopidogreal serve as more of a secondary intervention. These drugs are administered orally at doses of 325 mg for aspirin and 75 mg for clopidogrel. Side effects of these drugs include bleeding in the stomach and intestines.
References
- "Current Treatment Options in Neurology": New Treatments in Acute Ischemic Stroke; Michael J. Schneck, M.D.; November 2005
- "Circulation: Journal of the American Heart Association"; Treatment of Blood Clots; Samuel Z. Goldhaber, M.D.; 2002
