Thrombosis & Clotting
WHAT IS THROMBOPHILIA?
Thrombophilia is a disorder that cause an increased tendency toward excessive blood clotting in the veins and arteries. It is also referred to as hypercoagulability or prothrombotic state.
Protein substances in the blood work with tiny particles called platelets to form the blood clot in a process called coagulation, a natural, life-saving mechanism in injuries because it slows blood loss. Blood clots inside blood vessels form thrombus. These clots in the blood vessel can either partially or completely block the flow of blood in the vessel in the body.
Blood clots can occur in the veins of the arms, legs, or even the lungs. The kind of clot that occurs in the lungs is called a pulmonary embolus, and prevents blood from reaching the lungs. Blood clots can cause at-risk women to have miscarriages. A clot that blocks a blood vessel in the brain can cause a stroke, while a clot in a blood vessel in the heart can cause a heart attack.
WHAT YOU NEED TO KNOW
A clot inside a blood vessel is called a thrombus. When abnormal clotting occurs inside the blood vessel, it can fully or partially block the flow of blood to the extremity it normally supplies. Sometimes the blood clot can travel through the bloodstream and get stuck in a smaller vessel in the lungs. This kind of clot is referred to as a pulmonary embolus, and prevents blood from reaching the lungs. Blood clots can cause at-risk women to have miscarriages. A clot that blocks a blood vessel in the brain can cause a stroke, while a clot in a blood vessel in the heart can cause a heart attack.
There are risk factors that increase the chances of developing a dangerous clot. Usually, more than one of the risk factors needs to be present in order for the clot to form. A person is more likely to be at risk of deep-vein thrombosis (DVT) if:
- They have injured the deep veins in their arms or legs (for example, a broken bone, severe muscle injury, or have had surgery)
- The blood flow through the veins is slowed during long car, bus, train or airplane rides; or improper rest
- The person has an inherited or acquired risk factor, like Factor V Leiden or Protein C deficiency
- There is previous history of a blood clot
- There is a family member who has had a clot in the past
- People with a combination of these risk factors are at a higher risk for blood clots being formed, than people with fewer risk factors
The most common place for a blood clot is in the leg. You may have swelling, pain and redness in the calf or behind the knee. A rare site for clotting is in the lungs, which makes it hard to breathe. In even rarer cases, the clot might occur in the arm or another part of the body. Again, swelling, pain and/or redness may be present in the area of the clot.
There are medicines that can thin blood, making it less likely to clot. Some people with thrombophilia only need to take blood thinning medications when they have an increased risk factor such as surgery, trauma, pregnancy, or long plane rides or extended car trips. Other people with thrombophilia need to take medicine for the rest of their lives.
The two most common blood thinning medications are Heparin and Warfarin.
Usually, your doctor will give you heparin first, because heparin works right away. Heparin comes in two forms and if you are in the hospital, you may get your heparin through an IV. At home, heparin must be injected under the skin.
After being on heparin for the time suggested by your doctor, you might start taking warfarin. Warfarin is taken by mouth and takes longer to begin working so you should continue the heparin until the warfarin is working effectively. There are other treatment regimens that have a safer adverse effect profile such as enoxaparin sodium, apixaban, rivaroxaban, and others that our treatment center may prescribe to patients based on the needs and evaluation of the patient.
These medications can cause you to bleed more easily. You might notice that cuts take longer to clot and that you may bruise more easily. If you have any unusual bleeding, please go to the closest emergency room and call your doctor right away.
- Avoid standing or sitting in the same position for long periods of time, such as in long car or plane rides
- Avoid oral birth control or hormone therapy (consult physician)
- Consult your physician before becoming pregnant
- Exercise regularly, for instance walking, jogging, and swimming, and keep your weight at a normal level
- Avoid smoking
- Avoid alcohol
- Keep well hydrated
- Check your cholesterol regularly
- Consult your physician when you have an infection and are on medications
- Prevent venous stasis by wearing compression stockings or elevating legs