What Is Virchow’s Triad?
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Virchow’s Triad - Components, Clinical Significance, and Complications

Published on Dec 15, 2022 and last reviewed on Jun 09, 2023   -  4 min read


Virchow's triad includes wall damage to intravascular vessels and the presence of the hypercoagulable state. This article is an overview of Virchow's triad.


Virchow's triad is a combination of symptoms that help identify and diagnose the formation of thrombosis. Deep vein thrombosis is one of the conditions diagnosed due to Virchow's triad's presence. As the name suggests, Virchow's triad includes three characteristic features: wall damage of deep vessels, the presence of the increased blood clotting state, and flow stasis. Rudolf Virchow, a physician and scientist, described this triad over a century ago.

  • The slowing down of blood flow in the veins occurs because of obstruction in the vein. This increases blood viscosity, thus forming a clot in the blood vessel. These microthrombi do not get flushed out by any fluid movement and may grow in size.

  • Damage to the endothelial layer of the blood vessels can result from external or internal trauma. In addition, it can also be a result of trauma during surgery.

  • When there is an imbalance in the chemical and circulatory factors of the blood, the body develops a hypercoagulable state. Increased circulating tissue activation factor and decreased fibrinolysis and antithrombin in circulating plasma lead to a hypercoagulable state.

What Is the Clinical Significance of Virchow's Triad?

Virchow's triad demonstrates the underlying cause and physiology in the formation and development of venous thrombosis. If the healthcare provider can understand the underlying physiological changes of thrombus development, several diseases and conditions can be diagnosed earlier. This will eventually save the patient from suffering through a particular disease. If a blood clot is formed in locations such as blood vessels- arteries, and veins, the patient is at a high risk of being diagnosed with any of the following mentioned below.

What Are the Components of Virchow's Triad?

Virchow's triad includes three components. It should be noted that the German physician and scientist, Rudolf Virchow, did not intend to develop the triad. It was only after his death that scientists correlated his work and established the efficiency of the three components that help, to a large extent, in diagnosing several medical conditions, as mentioned above. It was thus named Virchow's triad after Rudolf Virchow.

Mentioned below are the three components of Virchow's triad.

  • Stasis or the phenomenon of interrupted flow of the blood. This is the very first component of Virchow's triad. It includes changes and alterations in blood flow due to multiple situations. Some of these situations may be prolonged surgical operations, venous stasis, long-standing immobility, being on an extremely long flight, being bound to bed due to hospitalization, varicose veins, or even sitting idle for long periods.

  • Injury to the walls of the blood vessels. In case of an injury in the walls of the blood vessels, epithelial injury occurs immediately. This phenomenon is concurrent with irritation of and around the blood vessel. Piercing of the blood vessel, shear stress, hypertension, and injuries are some of the ways that may damage the epithelial layer of the blood vessel. In such cases, the surface of the blood vessel is exposed. It is in direct contact with microorganisms such as bacteria, foreign substances, medical devices, implant biomaterials, monocyte membranes, and platelets that have been activated. This particular contact leads to an inflammatory response at the site of blood vessel injury.

  • The phenomenon of hypercoagulation of blood. Hypercoagulability refers to the formation of a blood clot due to genetic factors or changes in the molecular structure of blood. In this phenomenon, blood starts to clot extremely fast. Hypercoagulability may result from late pregnancy and delivery, the habit of cigarette smoking, administration of hormonal contraceptives, obesity, trauma, cancer, protein deficiency- especially protein S and protein C, a case of burns patient or nephrotic syndrome.

What Is Venous Thrombosis?

Deep vein thrombosis is also referred to as venous thrombosis. When a patient suffers from venous thrombosis, the formation of blood clots becomes extremely easy and quick for the body. The blood clot generally occurs in the deep veins of the legs. Nevertheless, blood clots or thrombi may also appear elsewhere in the body. These huge clots tend to lodge in wider blood vessels, such as the lungs' blood vessels. The causes of venous thrombosis have been associated with trauma which can be external or during a surgical procedure. Several treatment modalities can cure deep vein thrombosis or venous thrombosis. Virchow's triad consists of three classical findings that are positive in case a patient is suffering from venous thrombosis or deep vein thrombosis.

What Are the Signs and Symptoms of Venous Thrombosis?

Venous thrombosis, also called deep vein thrombosis or DVT, is considered a disease that is not caused by a single reason or physiology.

Below are a few signs and symptoms of venous thrombosis or deep vein thrombosis.

  • Pain in the calf.

  • Discomfort in the foot.

  • Warm skin.

  • Tenderness on percussion.

  • Swelling of the legs.

  • Ulcers in the leg are called venous stasis ulcers.

  • Discoloration of the skin.

  • Hyperpigmentation.

  • Difficulty in standing or walking.

  • Huge visible veins that look abnormally wide.

  • Pain in the abdomen.

  • Episodes of severe headache.

  • Seizures.

  • Redness of the skin.

  • Sudden shortness of breath.

  • Chest pain.

  • Cramps in the muscles of the legs.

  • Throbbing sensation.

  • An increase in the heart rate.

  • Charley horse.

  • Distension of the blood vessels.


Virchow's trials are three vital components that help evaluate and diagnose several thrombotic conditions. Deep vein thrombosis or venous thrombosis is one of the medical conditions that hugely depends on the presence of Virchow's triad in a patient. Venous thrombosis is a multifactorial disease. The good news is that venous thrombosis can be easily cured if and when diagnosed early and accurately.

Last reviewed at:
09 Jun 2023  -  4 min read




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