Hypercoagulable States: Types, Symptoms, Treatment
Overview
Hypercoagulable state is the medical term for a condition where there is an abnormally increased risk toward blood clotting. It is also known as blood clotting disorders or thrombophilia. There are many different types of hypercoagulable states and all have different causes. But the common theme among them is that they all increase the patient’s chances of developing a clot.
If hypercoagulable states are not properly diagnosed and treated, they can threaten your life. Hypercoagulable states may cause blood clots in your arteries, increasing your risk for stroke, heart attack, severe leg pain, difficulty walking, or even the loss of a limb.
Types & Causes
Hypercoagulable states can be inherited or acquired later in life. The genetic form of this condition means that a person is born with the tendency to form blood clots. Acquired disorders are usually resulted from surgery, trauma, medications or a medical condition that increases the risk of hypercoagulable states.
Types of inherited hypercoagulable states include:
- Factor V Leiden, which is the most common one
- Prothrombin gene mutation
- Increased homocysteine levels
- Deficiencies of natural proteins that prevent clotting
- Abnormal fibrinolytic system
- Elevated levels of fibrinogen or dysfunctional fibrinogen
- Elevated levels of factor VIII
Acquired hypercoagulable conditions involve:
- Cancer
- Recent surgery or trauma
- Pregnancy
- Obesity
- Supplemental estrogen use, such as use of birth control pills
- Hormone replacement therapy
- Heart attack
- Prolonged immobility or sedentary lifestyle
- HIV/AIDS
- Inflammatory bowel syndrome (IBS)
- Nephrotic syndrome (too much protein in the urine)
- Some medications used to treat cancer, such as tamoxifen and bevacizumab
Symptoms
It is impossible to tell if someone has hypercoagulable states or not by just looking at them. Because the major sign or symptom of a hypercoagulable state is a decreased or increased clotting factor.
In the case of decreased clotting factor, the primary sign is excessive bleeding, also known as hemorrhaging. This means that the patient will find it difficult to stop the bleeding after small scrapes or cuts. In terms of increased clotting factor, the patient has irregular clotting (thrombosis) where the patient experiences blood clots.
Diagnosis
To have a definite diagnosis of hypercoagulable states, your doctor will carefully evaluate your medical and family history. If the doctor suspects that you have hypercoagulable states, he or she may order some lab tests to further check your condition. These lab tests include:
- PT-INR.
The prothrombin time (PT or protime) test is used to calculate your International Normalized Ratio (INR). The information is used to monitor your condition if you are taking warfarin (Coumadin). Your INR will help your doctor determine how fast your blood is clotting.
This measures the time it takes blood to clot. This test is used to monitor your condition if you are taking heparin.
Genetic tests are needed if your doctor wants to diagnose inherited hypercoagulable states.
Treatment
Only when a blood clot develops in a vein or artery will you need the treatment. Based on your symptoms and severity, treatment options that you can choose include:
- Anticoagulants.
This type of medication can decrease the blood’s ability to clot and prevent the formation of additional clots. Examples include warfarin (Coumadin), heparin or low molecular weight heparin and fondaparinux (Arixtra).
- R.I.C.E. (Rest, Ice, Compression, Elevation).
Following these simple steps will stop the bleed and reduce your pain and swelling.
- Desmopressin.
This is a man-made hormone which is like vasopressin, a natural hormone. It helps in stimulating the body to produce more clotting factor VIII.
- Replacement Therapy.
In this therapy, the patient is given infusions of concentrated clotting factor which helps in stopping an ongoing bleeding.
- Surgery.
If there is accumulation of blood in the joint due to hemorrhage, then surgery may be needed to relieve the pressure and swelling.
- Joint Strengthening.
It is important for patients to exercise regularly to keep the joints strong and help in preventing of bleeds.
Keyword: hypercoagulable states.