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Cardiology Research and Practice
Volume 2011, Article ID 394740, 11 pages
http://dx.doi.org/10.4061/2011/394740
Review Article

Arterial and Venous Thrombosis in Cancer Patients

1University of Birmingham Centre for Cardiovascular Sciences, Department of Medicine, City Hospital, Birmingham B18 7QH, UK
2Department of Biomedical Science & Physiology, School of Applied Sciences, Research Institute in Healthcare Sciences, University of Wolverhampton, Wulfruna Street, Wolverhampton WV1 1AD, UK

Received 22 October 2010; Accepted 4 January 2011

Academic Editor: Syed Wamique Yusuf

Copyright © 2011 Andrew D. Blann and Simon Dunmore. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin), especially in high risk groups (such as those who are immobile and on high dose chemotherapy), may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.