Blood clotting disorder - find a doctor and information

What is a blood clotting disorder?

Blood coagulation disorders (coagulopathies) are diseases in which blood coagulation (hemostasis) is too strong or too weak.

The aim of blood coagulation is to solidify or clot the liquid blood. This process is vital for our body. It prevents us from losing a lot of blood in the event of minor injuries.

If blood coagulation is too weak, this is exactly what happens. Even minor injuries lead to major blood loss. If blood coagulation is too strong, on the other hand, dangerous blood clots form more easily.

Various substances are important for coagulation:

• Blood platelets (thrombocytes): They play a decisive role. They cross-link and form clots and ensure the closure of injured blood vessels. In the case of open injuries, protein fibers (fibrin) are deposited on the platelets and permanently seal the wound.
• Enzymes and clotting factors (clotting proteins): Several steps are required to ensure that blood clotting only occurs actively at the injured site. The coagulation factors activate each other and ensure that the next step begins.

If the chain reaction does not function properly, the blood clots with a delay or not at all.

Types of blood clotting disorders

Doctors differentiate between minus and plus blood clotting disorders:

In a minus blood clotting disorder, the blood clotting is too weak or non-existent. Wound healing takes a very long time. With a plus coagulation disorder, on the other hand, the blood clots too quickly.

• Minus coagulation disorders

The best-known minus blood clotting disorder is hemophilia. Hemophilia almost exclusively affects men. Depending on which clotting factor is missing, doctors speak of haemophilia A or B. Around 1 person in 10,000 in Germany suffers from haemophilia A. Haemophilia B affects around 1 person in 30,000.

Another minus blood clotting disorder is Von Willebrand-Jürgens syndrome, which, together with hemophilia, accounts for more than 95 percent of minus blood clotting disorders. In this disease, the Von Willebrand coagulation protein is inactive or absent.

• Plus blood coagulation disorders

Plus coagulation disorders (more common overall than minus coagulation disorders) include a tendency to thrombosis (thrombophilia). In patients with a tendency to thrombosis, certain properties of the blood (blood cells, blood plasma, blood flow) are altered. There is a high risk of suffering a vascular occlusion due to a blood clot (thrombosis).

In the event of a thrombosis, the blood accumulates. The leg can swell, hurt and become red @ hriana /AdobeStock

Causes of a blood clotting disorder

Causes of blood clotting disorders are congenital or acquired.

In most cases, minus blood clotting disorders are present from birth. Errors in the genetic material lead to certain blood clotting proteins not being present or being inactive.

Acquired blood clotting disorders usually occur at an older age. They are a consequence of medication, cancer or immune system diseases.

Other factors promote thrombosis:

• Increased age (women over 40 and men over 50)
• Being overweight
• Prolonged lack of exercise
• Varicose veins
• injuries
• Major operations
• Lack of fluids
• Smoking
• Taking the pill
• Pregnancy

Symptoms of a blood clotting disorder

The symptoms depend on the type of coagulation disorder. The symptoms can be mild or severe. If the coagulation disorder is mild, there are no symptoms in everyday life. Therefore, many people do not notice the disease.

Symptoms of reduced blood clotting

If blood coagulation is significantly reduced, wounds do not heal quickly enough and continue to bleed for a long time. Spontaneous and painful bleeding in tissues is possible. In most cases, slight pressure causes bruising.

Other typical symptoms of reduced blood clotting are

• Frequent nosebleeds
• Bleeding gums
• Blood in the stool/urine
• Heavy menstrual bleeding
• Headaches
• Visual disturbances

Symptoms of increased blood clotting

Blood clotting disorders with increased blood clotting cause symptoms if there is a blood clot. Thromboses can affect all organs and parts of the body, usually the legs.

Typical signs of vascular occlusion of a leg vein are

• Swelling of the legs/feet
• Feeling of heaviness and pain in the affected leg/foot
• Feeling of warmth
• Reddish or bluish discoloration
• Calf pain

The symptoms improve when you elevate your legs. In the worst case, a thrombosis can lead to a pulmonary embolism. A pulmonary embolism usually manifests itself as dizziness and shortness of breath.

If a blood clot interrupts the blood supply to the brain, the patient suffers a stroke.

Typical symptoms of a stroke are headaches, dizziness, paralysis, confusion and impaired vision and speech.

In all cases, consult a doctor immediately!

Compression stockings support better blood flow in the leg and prevent thrombosis @ tibanna79 /AdobeStock

Diagnosis of a blood clotting disorder

1. Medical history: First of all, the doctor will conduct a thorough medical history interview with you to determine any possible pre-existing conditions or illnesses.
2. Physical examination: During the physical examination, the doctor will diagnose bleeding in tissues or hematomas.
3. Blood tests: Coagulation tests are the most important methods for diagnosis. They provide coagulation values and the number of blood platelets.
4. Bone marrow examination: An examination of the bone marrow provides information about the number of blood platelets.
5. Doctors diagnose vascular occlusions using blood tests, ultrasound or computer tomography.

Treatment of a blood clotting disorder

Treatment depends on the cause:

• In the case of acquired coagulation disorders, doctors treat the cause (for example, another disease).
• Patients with severely reduced blood clotting receive injections (at regular intervals) with the missing clotting factors (or platelets). Certain medications are not permitted for these patients. The risk of injury should be kept as low as possible.
• If blood clotting is too strong, medication (acetylsalicylic acid, heparin) is administered in the form of injections, tablets or infusions. These drugs dissolve the blood clot. In severe cases, surgery is necessary to remove the blood clot. Preventive measures (compression stockings, anticoagulant medication) must be taken in high-risk situations (e.g. long-haul flights).