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Antithrombotics (Antiplatelets) and Intra-arterial Thrombus Formation

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Inhibitors of platelet aggregation

Activation of platelets, e.g., upon contact with collagen of the extracellular matrix after injury to the vascular wall, constitutes the immediate and decisive step in initiating the process of primary hemostasis, i.e., cessation of bleeding. However, in the absence of vascular injury, platelets can be activated as a result of damage to the endothelial cell lining of blood vessels. Among the multiple functions of the endothelium, the production of NO and prostacyclin plays an important role.

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Anticoagulants and Fibrinolytics – Summary

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Structurally related to vitamin K, 4-hydroxycoumarins act as “false” vitamin K and prevent regeneration of reduced (active) vitamin K from vitamin K epoxide, hence the synthesis of vitamin K-dependent clotting factors. Coumarins are well absorbed after oral administration. Their duration of action varies considerably. Synthesis of clotting factors depends on the intrahepatocytic concentration ratio of coumarins to vitamin K.

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Consider Aortic Dissection in Patients with Chest Pain and Ischemic ECGs

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In Aortic Dissection, a defect in the aortic intima allows entry of blood into the tunica media. A false lumen develops and can propagate in an anterograde or retrograde direction. Aortic Dissections that involve the ascending aorta (Stanford type A) can cause coronary insufficiency by several mechanisms.

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