Thrombophilia, also called hypercoagulability or prothrombotic state, is a disorder that puts patients at an increased risk for excessive blood clotting in the veins and arteries. Substances in your blood (called proteins) work with tiny particles (called platelets) to form blood clots, or “coagulation.” Coagulation is a natural, life-saving mechanism that prevents or slows blood loss after an injury. However, blood traveling freely through the veins should not clot, and when it does it is called “thrombosis.” When thrombosis occurs, a clot can either partially or completely block the flow of blood in the vessel, even though there has not been an injury to the vein. This tendency to clot too much is called hypercoagulability or "thrombophilia."
When abnormal clotting occurs inside the blood vessel of a person with thrombophilia, it can slow or stop blood flowing from veins, or to arteries, in the arms, legs and other areas of the body that normally have blood flow. A clot inside a blood vessel is called a "thrombus,” and sometimes the thrombus can break loose and travel through the bloodstream, lodging itself in a vessel in the lungs. This kind of clot is called a "pulmonary embolus", and can result in difficulty breathing and strain on the heart, which can be life-threatening. Blood clots can cause at risk women to have miscarriages. Blood clots can also block vessels in the brain and arteries in the heart, causing strokes and heart attacks, respectively.
There are several factors, called risk factors, that increase your chances of developing a dangerous clot. Usually, a person must have several risks factors in order to form a clot of this nature. You are more likely to be at risk of deep-vein thrombosis (DVT) if:
- You have a significant injury (for example, a broken bone, severe muscle injury or have surgery) or state of sustained inflammation (sever infection, lupus).
- The blood flow through your veins is slowed due to a prolonged state of decreased activity or mobility, such as a long car, bus, train or airplane ride, significant leg or arm injury or bed rest.
- You have an inherited or acquired thrombophilia risk factor, like Factor V Leiden or Protein C deficiency.
- You have a previous history of a blood clot.
- You have a family member who has had a clot in the past.
The most common place for a clot is in the leg. You may have swelling, pain and redness in the calf or behind the knee, or higher up in the leg or groin. Clotting in the lungs can cause shortness of breath, painful breathing, or chest pain. Clots in the veins or arteries of the brain often cause sever headache, sudden one-sided weakness, blurred vision, or difficulty speaking. Sometimes clots may cause no symptoms, especially in other areas of the body.
There are medicines that can thin the blood and make it less likely to form a clot. Some people with thrombophilia only need to take blood-thinning medications when they have an increased risk such as surgery, trauma, pregnancy or long plane/car trip. Other people with thrombophilia need to take preventative medicine at all times.
The two most common blood-thinning medications used in recent years are called heparin and warfarin. Usually, your doctor will give you heparin first, because heparin works right away. Heparin is frequently administered through an IV in hospitals, but patients may go home on heparin that is injected under the skin. After being on heparin for a while, your doctor might suggest that you start taking warfarin. Warfarin is taken by mouth and takes longer to begin working patients will continue taking heparin until the warfarin starts working in your blood. Antibiotics, infections, and changes in diet can alter Warfarin's effectiveness.
As blood thinners, these medications can cause a patient to bleed more easily than normal. You might notice that cuts take longer to stop bleeding and that you may bruise more easily. Special precautions should be taken against head injury, (for example: avoiding contact sports; using a helmet while riding a bike; always using seatbelts in motor vehicles; etc.). If you have any unusual bleeding, call your doctor right away.
- Consult your physician if you have a personal or family history of blood clots.
- Avoid standing or sitting in the same position for long periods of time.
- Avoid estrogen-containing birth control or hormone replacement therapy if you have a personal or family history of clots, and consult a physician.
- Exercise regularly (walking, jogging, swimming, etc.) and keep your weight at a normal level.
- Avoid smoking.
- Avoid excessive alcohol use.
- Stay well-hydrated.
- Check your cholesterol regularly.
- Consult your physician when you have an infection and are on warfarin.