Blood Clotting Disorder - Find a Doctor and Get Information

Blood clotting disorders (coagulopathies) are conditions in which blood clotting (hemostasis) is either too strong or too weak. 

The purpose of blood clotting is to solidify or coagulate liquid blood. This process is vital for our bodies; it prevents us from losing large amounts of blood during minor injuries. 

When blood clotting is too weak, that is exactly what happens. Even minor injuries lead to significant blood loss. When blood clotting is too strong, on the other hand, dangerous blood clots form more easily.

Various substances are important for clotting:

• Blood platelets (thrombocytes): They play a crucial role. They form a network and clump together, sealing injured blood vessels. In open wounds, protein fibers (fibrin) attach to the platelets and permanently seal the wound.
• Enzymes and clotting factors (clotting proteins): Several steps are required to ensure that blood clotting occurs only at the site of the injury. The clotting factors activate one another and trigger the next step in the process.

If this chain reaction does not function properly, blood clotting is delayed or does not occur at all.

Medical professionals distinguish between “minus” and “plus” blood clotting disorders:

In a “minus” blood clotting disorder, blood clotting is too weak or absent. Wound healing takes a very long time. In a “plus” blood clotting disorder, on the other hand, the blood clots too quickly. 

• Minus Blood Clotting Disorders

The best-known “minus” blood clotting disorder is hemophilia. Hemophilia affects almost exclusively men. Depending on which clotting factor is missing, doctors refer to it as hemophilia A or B. About 1 in 10,000 people in Germany has hemophilia A. Hemophilia B affects about 1 in 30,000 people.

Another type of deficiency-related blood clotting disorder is von Willebrand-Jürgens syndrome, which, together with hemophilia, accounts for more than 95 percent of all deficiency-related blood clotting disorders. In this disorder, the von Willebrand coagulation protein is inactive or absent.

• “Plus” blood clotting disorders

Plus blood clotting disorders (which occur more frequently overall than minus clotting disorders) include a tendency toward thrombosis (thrombophilia). In patients with a tendency toward thrombosis, certain properties of the blood (blood cells, blood plasma, blood flow) are altered. There is a high risk of developing a blood clot that blocks a blood vessel (thrombosis).

When thrombosis occurs, blood pools. The leg may swell, become painful, and turn red @ hriana /AdobeStock

Causes of blood clotting disorders can be congenital or acquired. 

Deficiency-type blood clotting disorders are present from birth in most cases. Genetic defects cause certain blood clotting proteins to be absent or inactive.

Acquired blood clotting disorders usually occur later in life. They are a result of medications, cancer, or immune system disorders.

Other factors that increase the risk of thrombosis include:

• Advanced age (women over 40 and men over 50)
• Obesity
• Chronic lack of physical activity
• Varicose veins
• Injuries
• Major surgeries
• Dehydration
• Smoking
• Taking the birth control pill
• Pregnancy

Symptoms depend on the type of clotting disorder. Symptoms can range from mild to severe. In cases of mild clotting disorders, there are no symptoms in everyday life. As a result, many people are unaware they have the condition.

Symptoms of Reduced Blood Clotting

When blood clotting is significantly impaired, wounds do not heal quickly enough and continue to bleed for a long time. Spontaneous and painful bleeding in tissues may occur. Bruises usually appear with even slight pressure.

Other typical symptoms of reduced blood clotting include:

• Frequent nosebleeds
• Bleeding gums
• Blood in the stool or urine
• Heavy menstrual bleeding
• Headaches
• Vision problems

Symptoms of increased blood clotting

Blood clotting disorders characterized by increased blood clotting cause symptoms when a blood clot is present. Thrombosis can affect any organ or part of the body, but most commonly affects the legs.

Typical signs of a blocked vein in the leg include:

• Swelling of the legs/feet
• Heaviness and pain in the affected leg or foot
• A sensation of warmth
• Reddish or bluish discoloration
• Calf pain

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

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

Typical symptoms of a stroke include headache, dizziness, paralysis, confusion, and vision and speech problems.

In all cases, seek medical attention immediately!

Compression stockings promote better blood flow in the legs and help prevent blood clots @ tibanna79 /AdobeStock

1. Medical history: First, the doctor will conduct a thorough medical history interview with you to identify any potential risk factors or pre-existing conditions.
2. Physical examination: During the physical examination, the doctor will check for bleeding in the tissues or hematomas.
3. Blood tests: Coagulation tests are the most important diagnostic tools. They provide coagulation values as well as the platelet count. 
4. Bone Marrow Examination: A bone marrow examination provides information about the platelet count.
5. Doctors diagnose vascular occlusions using blood tests, ultrasound, or computed tomography.

Treatment depends on the cause:

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