HYPERCOAGULATION DISORDERS: EXCESSIVE CLOTTING
What is hypercoagulation?
When you get a cut, your body stops the bleeding by forming a blood clot (a thickened mass). Substances in your blood (called proteins) work with tiny particles (called platelets) to form the clot. Forming a clot is called coagulation. Coagulation helps when you are injured because it slows blood loss. However, your blood shouldn't clot when it's moving through your body in your blood vessels. The tendency to clot too much is called hypercoagulation. It can be very dangerous.
Why is hypercoagulation dangerous?
A clot inside a blood vessel is called a thrombus. Sometimes the thrombus can travel in the bloodstream and get stuck in your lungs. This kind of clot (called a pulmonary embolus) keeps blood from getting to your lungs. A pulmonary embolus can be life-threatening.
A clot that blocks a blood vessel in the brain can cause a stroke. A clot in a blood vessel in the heart can cause a heart attack. Blood clots can cause some women to have miscarriages.
What causes hypercoagulation?
There are proteins in your body that are supposed to keep your blood from clotting too much. some people don't make enough of these proteins. In other people, these proteins aren't doing their job properly. Or a person may have an extra protein in their blood that causes too much clotting. Hypercoagulation has a few other causes, but those causes are rare.
Some people are born with a tendency to develop clots. This tendency is inherited (comes from your parents).
Certain situations or risk factors can make it easier for your blood to clot too much. These situations include the following:
- Sitting on an airplane or in a car for a long time
- Having prolonged bed rest (several days at a time)
- Having surgery
- Having cancer
- Being pregnant
- Using birth control pills
How do I know if I have a problem with hypercoagulation?
Your doctor might think that you have a problem with hypercoagulation if any of the following are true:
- You have relatives with abnormal or excessive clotting.
- You had an abnormal clot at a young age.
- You got clots when you were pregnant or were using birth control pills.
- You have had several unexplained miscarriages.
If your doctor suspects you have hypercoagulation, tests can check the proteins in your blood. The tests will also show if your proteins are working the right way.
Can hypercoagulation be treated?
Yes. Several medicines can thin your blood and make it less likely to clot. Some people with hypercoagulation only need to take blood thinners when they're in a situation that makes them more likely to form clots--like when they're in the hospital recovering from surgery, when they're in a car or airplane for a long time, or when they're pregnant. Other people need to take medicine on an ongoing basis for the rest of their lives. Your doctor will decide what treatment is right for you.
What medicines are used to treat hypercoagulation?
The two most common blood thinners are called heparin and warfarin (brand name: Coumadin). Your doctor will probably give you heparin first, because heparin works right away. Heparin must be injected with a small needle under the skin. Once the heparin starts working, your doctor will probably have you start taking oral warfarin. Warfarin takes longer to begin working.
What are the side effects of these medicines?
Both medicines can cause you to bleed more easily. If you cut yourself, you might notice that the blood takes longer to clot. You might bruise more easily. If you have any unusual or heavy bleeding, call your doctor.
Warfarin has a stronger effect on some people than on others. If you take warfarin, your doctor will want to check you often with a blood test that tells your doctor how well the warfarin is working. Some other medicines can make warfarin more or less strong. Ask your doctor before you take a new medicine, even over-the-counter medicines and vitamins. Also, talk to your doctor about foods you should avoid while taking warfarin.
If you're pregnant, you shouldn't take warfarin. Warfarin can cause birth defects. Instead, you must use heparin until you have your baby. If you want to get pregnant and you're already taking warfarin, talk with your doctor about changing to heparin. Sexually active women who take warfarin should use birth control.
Adapted from American Academy of Family Physicians