Blood Clot Disorders

What is blood clotting?

Blood clotting occurs when blood in the body becomes clustered and forms clumps, which help to heal wounds and cuts faster (hemostasis). However, too much clotting can be dangerous, resulting in blocked blood flow in capillaries and veins (thrombosis). Clotting factors such as factor VIII are usually involved in the process of blood clotting. Clotting factors are also referred to as coagulation factors. ¹

What are platelets?

Platelets are fragments in the blood which help with clotting. For example, when a healthy person gets a wound or a cut, chemical signals will allow platelets to arrive at the site of the injury to help stop the bleeding. This means that the injury site can develop a scab until the skin is recovered and the scab falls off. However, sometimes too much or too little clotting can occur, which means that the person is either bleeding too much or could experience problems in the veins if the injury clots very easily. ²

What is a hypercoagulable state?

A hypercoagulable state is a blood clotting disorder that refers to excessive blood clotting. This is also known as thrombophilia or thromboembolic disease. This means that blood clots are formed in important vessels such as the arteries, veins or capillaries, and the blood flow in vessels becomes blocked. This can be dangerous when the blood clot is blocking the blood flow in significant arteries such as the coronary arteries that are found in the heart. ³

Why is a hypercoagulable state dangerous?

If coronary arteries are blocked with blood clots, regular blood flow cannot pass through. As the coronary artery is attached to the heart, it will not be able to receive sufficient blood and, therefore, adequate amounts of oxygen. This means that the heart will not be able to pump enough blood around the body, which can lead to fatal consequences such as a heart attack or death. ³

What are the causes of hypercoagulable states?

There are many causes of hypercoagulable states. These include genetic and lifestyle factors that can increase blood clotting in the vessels. According to Cleveland Clinic, people with specific gene mutations or deficiencies in their natural proteins can inherit the disorder. 

Lifestyle or acquired factors can also be another way people develop hypercoagulable states. These include people who have to take certain blood clotting medications such as warfarin or specific cancer treatments. Additionally, being obese, pregnant, prone to heart conditions and having HIV/AIDS can lead to excessive blood clotting. ⁴

Hypercoagulable states - What are thrombus and embolus? 

There are two different types of hypercoagulable states. The first state is thrombus, where the blood clot forms in an important vessel and does not move. Damages to blood vessels, reduced blood flow or lack of valves in the vessels can cause thrombus. ⁵

The other type of hypercoagulable state is embolus. An embolism occurs when the clot formed in one vessel travels to another vessel and blocks it. This means that it usually travels until it reaches a vessel that is small enough to block. The small vessels that usually suffer the blockage are usually capillaries. ⁶

How can I treat hypercoagulable states? 

Hypercoagulable states can be treated with anticoagulant medications. These can be administered orally or subcutaneously, depending on the severity of the clot. Anticoagulants work as blood thinners and can be used to prevent the adhesion of red blood cells (which combine to make a clot). Anticoagulants work by preventing clotting factors and reducing the number of blood clots in the body. ²

Too little blood clotting 

There are also many genetic conditions which lead to too little clotting in the blood. These can be dangerous for people when they get cuts or wounds, increasing the risk of bleeding to death. These conditions include haemophilia, Von Willebrand disease, liver disease and vitamin K deficiency. ¹

What is haemophilia?

Haemophilia is a rare genetic condition which affects the body’s ability to clot. Clotting does not occur mainly because people with haemophilia do not have clotting factors (mentioned earlier). Haemophilia mainly affects males and was a largely inherited disease in the European Royal family in the 19th and 20th centuries. ⁷ 

What are the symptoms of haemophilia?

According to the Mayo Clinic, symptoms of haemophilia include excessive bleeding due to cuts and injuries which cannot heal, bleeding after vaccinations, pain and swelling within joints, blood in urine, and nosebleeds. In people with severe haemophilia, minor injuries such as injuries on the head can also lead to seizures and headaches, as well as patients being lethargic. 

In extremely rare conditions, haemophilia can be acquired as a consequence of pregnancy, cancer and autoimmune conditions such as multiple sclerosis. ⁷ 

What are the treatments for Haemophilia?

Haemophilia can be prevented by administering a series of injections with clotting factors that aid platelets in creating blood clots when there is a small cut or wound. In addition, people with different types of haemophilia can take various medications. ⁷ 

What is Von Willebrand disease? 

Von Willebrand disease is an inherited bleeding disorder characterised by excessive bleeding. It occurs in people who do not have the clotting protein Von Willebrand factor, leading to inadequate blood clotting. Although it does not have any cures, it can be managed. ⁸

What are the symptoms of Von Willebrand disease?

Symptoms of the Von Willebrand disease include excessive bleeding due to a lack of clotting factors, blood in stools and urine, and frequent nosebleeds. In women, large clots also form during menstruation, leading to heavy periods. ⁸

What are the treatments for Von Willebrand disease?

Much like haemophilia, Von Willebrand disease can be treated with intravenous or subcutaneous injections such as desmopressin, which promotes the release of stored Von Willebrand factor. However, couples with Von Willebrand disease who want to have children must seek guidance from doctors or counsellors beforehand. ⁸

What is liver disease?

Liver disease can be caused by a number of factors such as obesity, hepatitis infections and excessive alcohol consumption. This can lead to a lack of clotting factors and proteins in the body, which decreases the number of platelets in the blood, thus increasing the number of blood clots. ⁹

What are the symptoms of liver disease?

The symptoms of liver disease include jaundice – where the eyes and skin become yellow. Additionally, patients can experience symptoms such as pain and swelling, as well as itching and fatigue. Liver disease is also characterised by increased bile in the blood and therefore, darker colour of the urine. ⁹ 

What are the treatments for liver disease? 

There is no cure for liver disease, but the main treatments are maintaining a healthy lifestyle through reducing alcohol intake and losing weight, as well as actively managing the main symptoms of the disease. ⁹

How does vitamin K deficiency lead to reduced blood clots?

Vitamin K is usually very important for blood clotting, as it helps the formation of some essential proteins for blood clotting. Vitamin K can be taken through supplements and foods such as kale, spinach and broccoli. A vitamin K deficiency leads to excessive bleeding, which could lead to significant blood loss and death if not treated immediately. ¹⁰

Conclusion

Overall, blood clotting is an essential function in the body after an injury that promotes healthy healing. Therefore, any imbalances in this process can cause serious complications such as excessive bleeding or blockage of the vessels. If you are experiencing any of the symptoms stated above, make an appointment with your GP as soon as possible.