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What is hypercoagulation?
Hypercoagulation is the name for excessive blood clotting. When you get a cut, your body forms a thickened mass of blood tissue. Called a blood clot, this mass stops the bleeding. Proteins in your blood help form the clot. This process is called coagulation. Coagulation helps when you are injured because it slows blood loss.
Sometimes your blood forms a clot when it shouldn’t. The clot forms while the blood is moving through your body. This tendency of the blood to clot too much is called hypercoagulation. It can be very dangerous. Blood clots can form in vital organs or travel to them, including the heart and brain. This can cause serious health problems, even death.
Symptoms of hypercoagulation
The symptoms you may experience depend on where the blood clot forms or travels to.
In the heart or lungs, a blood clot could cause a heart attack or a pulmonary embolism (blood clot in the lungs). Symptoms could include:
- chest pain
- shortness of breath
- discomfort in the upper body, including chest, back, neck, or arms.
In the brain, a blood clot could cause a stroke. Symptoms could include:
- speech changes
- paralysis on one or both sides of the body.
In the lower body, a clot could cause deep vein thrombosis or peripheral artery disease. The symptoms of these include pain, redness, warmth, and swelling in the lower leg.
What causes hypercoagulation?
Some people are born with a tendency to develop clots. This tendency is inherited (which means it runs in your family). They may not have enough of the proteins that keep the blood from clotting too much. Or these proteins may not be doing their job properly.
Certain situations or risk factors can make it more likely for your blood to clot too much. These situations include:
- Sitting on an airplane or in a car for a long time.
- Prolonged bed rest (several days or weeks at a time), such as after surgery or during a long hospital stay.
- Surgery (which can slow blood flow).
- Cancer (some types of cancer increase the proteins that clot your blood).
- Pregnancy (which increases the pressure in your pelvis and legs and can cause blood clots to form).
- Using birth control pills or receiving hormone replacement therapy (which can slow blood flow).
In addition to these situations, you may be at risk of hypercoagulation if:
- You have relatives with abnormal or excessive clotting.
- You had an abnormal clot at a young age.
- You got clots when you were pregnant, were using birth control pills, or were being treated with hormone replacement therapy.
- You have had multiple unexplained miscarriages.
How is hypercoagulation diagnosed?
If your doctor suspects you have hypercoagulation, he or she will do a physical exam. They will ask about your family history to see if anyone else had problems with clotting. They can order blood tests to check the protein and platelet levels in your blood. The tests will also show if your proteins are working the way they should to properly clot your blood.
Can hypercoagulation be prevented or avoided?
There is nothing you can do to prevent hypercaogulation if it is inherited. To reduce your risk of developing blood clots, you can:
- Quit smoking.
- Maintain a healthy weight.
- Avoid medicines that contain the female hormone estrogen (such as birth control pills).
- Stay active during long car or plane trips to keep blood flowing.
- Treat conditions that could lead to excessive clotting, such as diabetes.
Hypercoagulation is usually treated with medicine. Some people only need to take the medicine when they’re in a situation that makes them more likely to form clots. This could be when they are in the hospital recovering from surgery. It could be when they are in a car or airplane for a long time, or when they are 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?
Most patients with hypercoagulation are treated with medicines called anticoagulants. These are also known as blood thinners. They make it harder for clots to form. They also can keep existing clots from growing bigger. Examples include heparin, warfarin, dabigatran, apixaban, and rivoraxaban.
Do these medicines have side effects?
Some anticoagulants do have side effects. Some can cause you to bleed more easily. If you cut yourself, you might notice that the blood takes longer to clot than usual. You might also bruise more easily. Call your doctor if you have any unusual or heavy bleeding.
If your doctor prescribes an anticoagulant, you should:
- Follow his or her instructions carefully.
- Get regular blood tests done if you take heparin or warfarin. This will show how well the medicine is working.
- Don’t take aspirin while you’re taking an anticoagulant unless your doctor tells you to. Aspirin can also thin your blood.
- Tell any other doctors you may see that you are taking an anticoagulant.
- Tell your doctor right away if you are pregnant or if you become pregnant. Some anticoagulants can cause birth defects.
- Check with your doctor before taking any other medicines or supplements. This includes prescription medicine, over-the-counter medicine, vitamins, or herbal supplements. Some of these medicines may strengthen or weaken your anticoagulant.
- Discuss your diet with your doctor if you take warfarin. Foods with a lot of vitamin K can reduce its effectiveness. These foods include leafy green vegetables, fish, lentils, soybeans, and some vegetable oils.
- Tell your family that you take anticoagulant medicine. Carry an emergency medical ID card with you at all times.
Living with hypercoagulation
Hypercoagulation can be very dangerous. A clot inside a blood vessel can travel in the bloodstream. It can get stuck in vital organs of your body. A clot that gets stuck in your lungs (pulmonary embolism) blocks blood from getting to your lungs. 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. All of these conditions can be life-threatening. So it is very important that hypercoagulation or abnormal clots be treated right away.
Questions to ask your doctor
- My father had problems with hypercoagulation. Am I at risk too?
- What are the symptoms of hypercoagulation?
- Is hypercoagulation dangerous? Am I at risk of a stroke?
- Can hypercoagulation be treated and cured?
- What can I do to prevent blood clots?
- What are the side effects of the medicine used to treat hypercoagulation?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.