How Do Blood Clots Dissolve?

When you get a cut, your blood changes from a free-flowing liquid into a clump of gel -- that’s a clot -- to stop the bleeding. That’s like if a hose could patch itself after it springs a leak.

It’s a complicated process where platelets, a type of blood cell, and lots of different proteins all jump in at just the right time to plug things up.

As the wound heals, your body has another process to break them down. If a clot forms when it’s not supposed to -- inside a blood vessel, for example -- you might need a little help to make that happen.

How the Body Clears Clots

When your body senses that you’ve healed, it calls on a protein called plasmin. Here’s the clever part: Plasmin is actually built into the clot itself. It’s there the whole time, but it’s turned off. It just hangs out and waits.

To turn it on, your body releases a substance known as an activator. It wakes up plasmin and tells it to get to work tearing things down. That mainly means breaking up the mesh-like structure that helps the clot work so well.

How Medicine Clears Clots

Doctors use different medications based on the type of clot you have:

Blood thinners. Also called anticoagulants, these are some of the more common drugs for a deep vein thrombosis (DVT). That’s a blood clot that happens in one of your large veins, usually in your leg. Blood thinners are also used to help prevent clots after a stroke or pulmonary embolism (when a blood clot travels to an artery in your lungs).

Blood thinners don’t dissolve the clot, but they can stop it from getting bigger and keep new ones from forming. That gives your body time to break up the clot.

Different blood thinners work in different ways:

  • Direct oral anticoagulants (DOACs) keep your body from making fibrin, the protein the forms the clot’s mesh.
  • Heparin keeps one of your body’s key clotting proteins, thrombin, from doing its job.
  • Warfarin (Coumadin) slows down your liver’s ability to make the proteins you need for clotting.

Thrombolytics. These clot-busting drugs are used for serious conditions, like a pulmonary embolism. Unlike blood thinners, they do break down the clot. They work by turning on plasmin, which jump-starts your body’s natural process for clearing things out.

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How Long Does It Take to Recover?

It’s not something you feel instantly. A DVT or pulmonary embolism can take weeks or months to totally dissolve. Even a surface clot, which is a very minor issue, can take weeks to go away.

If you have a DVT or pulmonary embolism, you typically get more and more relief as the clot gets smaller. The pain and swelling from a DVT usually start to get better within days of treatment.

Symptoms from a pulmonary embolism, like shortness of breath or mild pain or pressure in your chest, can linger 6 weeks or more. You might notice them when you’re active or even when you take a deep breath. Exercise can help with this.

A blood clot puts serious stress on your body. So it’s not just about clearing it away, but also giving your body and mind time to recharge.

Long-Term Effects

Sometimes a clot can leave behind scars and other damage that can cause problems.

Almost half of people who get a DVT may end up with post-thrombotic syndrome. That’s where swelling, pain, or skin color changes last much longer. You also may get sores called ulcers.

About 4 in 100 people with a pulmonary embolism have long-term lung damage known as pulmonary hypertension. This means you have high blood pressure in your lungs, which can lead to issues like shortness of breath, tiredness, and chest pain.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on March 25, 2018

Sources

SOURCES:

Mayo Clinic: “Blood Clots,” “Blood Clots in Surface Veins Often Treated with Self-care Techniques,” “Pulmonary Hypertension.”

American Society of Hematology: “Blood Clots.”

University of Southern California, Atherosclerosis Research Unit: “What is fibrinolysis?”

CDC: “Venous Thromboembolism (Blood Clots).”

American College of Physicians: “What You Should Know About Blood Clots.”

American Heart Association/American Stroke Association: “Anti-Clotting Agents Explained.”

Memorial Sloan-Kettering Cancer Center: “About Blood Clots and How to Treat Them.”

National Blood Clot Alliance: “Unfractionated Heparin (UFH),” “Warfarin,” “Direct Oral Anticoagulants (DOACs),” “Blood Clot Treatment and Recovery,” “Blood Clot FAQs – Deep Vein Thrombosis (DVT) and Pulmonary Embolism Follow Up Care.”

Medscape: “Thrombolytic Therapy.”

Clot Connect: “FAQ: When will my clot and pain go away?” “FAQ: When can I resume physical activities?”

NHS, St. George’s Healthcare: “Haematology: Pulmonary Embolus.”

Circulation: “Postthrombotic Syndrome.”

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