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Fibrinolysis - primary or secondary

Definition

Fibrinolysis is a normal body process. It prevents blood clots that occur naturally from growing and causing problems.

Primary fibrinolysis refers to the normal breakdown of clots.

Secondary fibrinolysis is the breakdown of blood clots due to a medical disorder, medicine, or other cause. This may cause severe bleeding.

Alternative Names

Primary fibrinolysis; Secondary fibrinolysis

Causes

Blood clots form on a protein called fibrin. The breakdown of fibrin (fibrinolysis) can be due to:

  • Bacterial infections
  • Cancer
  • Intense exercise
  • Not enough oxygen to tissues

Your health care provider may give you medicines to help blood clots break down more quickly. This may be done if a blood clot causes a heart attack.

Gallery

Blood clot formation
Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.
Blood clot formation
Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.

References

Brummel-Ziedins K, Mann KG. Molecular basis of blood coagulation. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 126.

Schafer AI. Hemorrhagic disorders: disseminated intravascular coagulation, liver failure, and vitamin K deficiency. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 166.

Weitz JI. Hemostasis, thrombosis, fibrinolysis, and cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 95.

Last reviewed January 25, 2022 by Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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