Blood Clotting Disorder: Symptoms, Causes, Diagnose & Treatment

 

Your body is more likely than usual to form blood clots if you have a blood clotting disease. One of these conditions may be inherited or acquired. You might not experience a severe blood clot that results in a stroke even if you have a blood clotting issue. Medications can prevent excessive blood clotting.

What is A blood clotting disorder?

If you have a blood clotting condition, such as thrombophilia or hypercoagulable state, your blood clots too quickly.

Your body forms a blood clot to stop the bleeding when you are getting hurt. To create a blood clot (coagulate), your liver produces clotting factors, which are proteins that adhere to platelets in your blood. For a cut to stop bleeding and begin the healing process, normal coagulation is essential.

However, too much clotting can cause problems.

Do blood clotting disorders pose a danger?

Indeed, blood clotting disorders can be dangerous, particularly if treatment is not done. A blood clot is more likely to occur in people with coagulation problems in their:
Blood clots in your veins have the potential to spread throughout your bloodstream and result in:

• Blood vessels called angiography transport blood out from the heart.
• Blood arteries called veins transport blood to the heart.

A thrombus or embolus is another name for a clot that forms inside a blood vessel.

Blood clots in your veins have the potential to spread throughout your bloodstream and result in:

• A blood clot in your pelvic, leg, arm, liver, intestines, or kidneys is known as deep vein thrombosis.
• A blood clot in your lungs is called a pulmonary embolus.

Arterial blood clots can increase your risk for:

• Stroke

• Heart attack

• Severe pain in the legs

• Walking difficulties

• Losing a leg or an arm

Symptoms:

The symptoms of a blood clotting problem can change based on the location of the clot.

Symptoms could consist of:

• A deep vein thrombosis may be the cause of your leg's swelling, soreness, and pain

• Breathlessness accompanied by chest pain may indicate a potential pulmonary embolism

• Heart attack

• Stroke

Causes:

The majority of hypercoagulable states are either acquired or hereditary (inherited from parents).

If you have the hereditary form of this illness, you are predisposed to blood clots from birth.

Typically, acquired disorders are brought on by trauma, surgery, medication, or medical conditions that raise the risk of blood clots.

 Inherited hypercoagulable condition:

•  Factor V Leiden

• Mutation in the prothrombin gene (G20210A)

• Deficiencies in natural proteins (such as antithrombin, protein C, and protein S) that inhibit coagulation

• Fibrinogen that is either malfunctioning or present in excess

• High concentrations of factor VIII as well as other factors including factor IX and XI

• Fibrinolytic system abnormality

 

Blood clotting diseases that are acquired include:

• APS stands for antiphospholipid syndrome.

• DIC stands for disseminated intravascular coagulation.

Causes of acquired blood clotting disorder:

• One of the most frequent reasons is cancer

• A few drugs used to treat cancer

• Recent surgery or trauma

• Insertion of a central venous catheter

• Being overweight

• Pregnancy

• Use of oral contraceptives, such as birth control tablets, as well as more estrogen

• Hormone replacement treatment

• Prolonged periods of bed rest or lengthy plane travel that prevent you from moving your body

• Heart attack, stroke, congestive heart failure, and other conditions that cause a decrease in activity

• Reduced platelets in your blood due to heparin or low molecular weight heparin preparations is known as heparin-induced thrombocytopenia

• Autoimmune disorders

• Syndrome of antiphospholipid antibodies

• Prior history of pulmonary embolism or deep vein thrombosis

• Polycythemia vera and essential thrombocytosis are examples of myeloproliferative diseases

• Nocturnal paroxysmal hemoglobinuria

• Syndrome of inflammation of the bowel

• Lacking in other B vitamins including folate

• Sepsis, HIV, or other illnesses

• Too much protein in your urine is known as nephrotic syndrome.

Diagnose:

Your doctor can assess your condition with the use of blood tests.

Tests for blood clot disorders include:

• PT-INR: If you are taking warfarin, the prothrombin time (PT) test aids your doctor in keeping an eye on your health. Your doctor will use your results to determine whether you require a new dosage and how quickly your blood is clotting.

• The time it takes for your blood to clot is measured by your activated partial thromboplastin time or aPTT. If you're taking heparin, your doctor uses this test to keep an eye on your health.

• Fibrinogen test

• Complete blood count (CBC). 

 Some of the tests help detect conditions that can be associated with hypercoagulable states.
 Tests used to help diagnose inherited coagulation disorders include:

•  Genetic tests, including factor V Leiden, activated protein C resistance, and prothrombin gene mutation (G20210A).

•  Antithrombin activity

•  Protein C activity

•  Protein S activity

•  Homocysteine test

Heparin antibodies (in individuals who develop low platelet counts while exposed to heparin) and components of the antiphospholipid antibody syndrome are additional tests that aid in the diagnosis of acquired coagulation problems.

Testing is beneficial:

• Determine if you are susceptible to further clotting.

• To avoid further clots, choose the appropriate treatment plan and duration.

• Find family members who might be at risk but do not exhibit symptoms at the moment.

The tests should be performed by a professional coagulation laboratory and interpreted by a pathologist or physician who specializes in coagulation, vascular medicine, or hematology.

The tests should ideally be performed when you are not experiencing an acute clotting episode.

What is the treatment for a blood clotting disorder?

Treatment for blood clotting disorders is typically only necessary when a blood clot forms in an artery or vein. Anticoagulants reduce the clotting power of your blood and stop new clots from forming.

Among the anticoagulant medications are:

• Aspirin

• The pill known as Warfarin (Coumadin® or Jantoven®) is swallowed

• Heparin is a liquid medication that is administered intravenously (IV) or by injection in a medical facility

• Once or twice a day, you receive an injection of low-molecular-weight heparin. It's yours to take home.

• The injection is called fondaparinux

• Direct oral anticoagulants, like dabigatran, apixaban, or rivaroxaban, in tablet form

The benefits and risks of these medications will be discussed with you by your healthcare professional. The type of anticoagulant medication you will take, how long you must take it, and the type of follow-up monitoring you require will all be influenced by this information as well as your diagnosis.

As with any medication, it's critical to follow your doctor's instructions regarding the proper dosage and timing of your anticoagulant as well as to get regular blood tests. If you are pregnant or intend to become pregnant, you should not take warfarin. If so, speak with your doctor about changing to a different type of anticoagulant drug, particularly in the first trimester and before giving birth.

How may a blood clotting disorder be prevented?

You cannot avoid a blood clotting issue if you are born with a hereditary type of it. That does not, however, imply that you will develop a blood clot.

The following are some potential strategies to avoid an acquired blood clotting disorder:

• Seeking non-estrogen substitutes for hormone replacement treatment or birth control tablets

• Maintaining a healthy weight

• Ensuring that you are receiving the necessary vitamins

• Getting up and moving around, particularly after surgery and on lengthy flights.

References:

• National Blood Clot Alliance. Direct Oral Anticoagulants (DOACs) (https://www.stoptheclot.org/about-clots/blood-clot-treatment/direct-oral-anticoagulants/). Accessed 7/5/2022.

• American Heart Association. What Is Excessive Blood Clotting (Hypercoagulation)? (https://www.heart.org/en/health-topics/venous-thromboembolism/what-is-excessive-blood-clotting-hypercoagulation) Accessed 7/5/2022.

• National Heart, Lung, and Blood Institute. What Are Blood Clotting Disorders? (https://www.nhlbi.nih.gov/health/clotting-disorders) Accessed 7/5/2022.

• MedlinePlus. Factor V Leiden thrombophilia. Prothrombin thrombophilia (https://medlineplus.gov/genetics/condition/factor-v-leiden-thrombophilia/#frequency). Accessed 7/5/2022.