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Closed eyes, non responding, no pulse. How long would it take for a blood clot to travel from heart to brain?

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Practicing since : 1981
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How long would it take for a blood clot to travel from leg to heart, from heart to brain? Husband passed away yesterday, trying to sleuth what happened. Fell off chair edge, limbs looked rubbery, boneless. Couldn't get up, said legs were burning. 60 seconds or so, WE finally got him into the chair, where he took a XXXXXXX breath, eyes closed, nonresponsive, then another XXXXXXX breath, maybe 60 to 90 seconds later, then nothing. Death. No wrist nor carotid pulse, no breathing, AICD did NOT activate.
Posted Sun, 15 Jul 2012 in Stroke
Answered by Dr. Anil Grover 5 hours later

Thanks for writing in.
I am a medical specialist with an additional degree in cardiology. I read your mail with diligence.
Please accept my heartfelt condolences on this untimely demise of your husband. Going through medical record which you have supplied. It is obvious, like a true soldier he fought, successfully, host of illnesses till the death snatched him away.

Let me reconstruct then final event and at the same time explain why certain things happened and why certain things did not happen.
XXXXXXX His both legs were rubbery without any power .. XXXXXXX breath and finally demise" This looks like posterior circulation stroke..rare but arteries supplying both limbs, respiratory center point to posterior (basilar artery). His speech, including the last words about legs as if they were burning means there was no slurring of speech and absence of one sided involvement exclude vascular event anterior circulation (more common middle cerebral artery territory). You are right in surmising it was a clot. In about one third of persons the dividing structure between two sides of heart at upper chamber level (inter atrial septum) is probe patent. Meaning right sided clot (may be from AICD leads) can travel to left side by passing the lungs and then to any part of body including brain. Breathlessness and pain point towards clot in the lungs causing lung infarcts. If he was bed ridden for some time, clots could have formed in leg veins also. It is then few seconds for clots to travel to any part of body including brain.

It was a sudden cardiac death and AICD remained silent excludes ventricular arrhythmic event. Everything thus is pointing towards clot. Respiratory center is also close by in the brain stem so with the involvement of lower limbs the respiratory center could have been involved and that is cause of primary respiratory arrest. Heart could have beaten for a while because of pacemaker which is inbuilt in AICD but given up soon in absence of brain activity.

I hope I have tried to answer the questions you have posed. If there is anything more where I can elaborate please write to me I will answer to best of my ability.


Dr Anil Grover
MBBS, MD (Internal Medicine) DM(Cardiology)
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