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OVERVIEW

What is hypercoagulation?

When you get a cut, your body forms a thickened mass of blood tissue called a blood clot. Proteins in your blood called help form the clot. This is called coagulation.

Sometimes, your blood clots too much. This is called hypercoagulation.  This 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

The symptoms you may experience depend on where the blood clot forms and where it travels. It can travel to many places, including the heart, lungs, brain, legs, and kidneys.

A blood clot in the heart or lungs can cause a heart attack or a pulmonary embolism (a name for blood clot in the lungs). Symptoms include:

• Chest pain.
• Shortness of breath.
• Discomfort in the upper body, including chest, back, neck, or arms.

A blood clot in the brain can cause a stroke. Symptoms include:

• Headache.
• Speech changes.
• Dizziness.
• Paralysis on one or both sides of the body.

A blood clot in the lower body may cause deep vein thrombosis (a blood clot deep inside your leg) or peripheral artery disease (when your arteries become narrow). Symptoms may appear in your leg and include:

• pain
• redness
• warmth
• swelling

A blood clot in the vein to one of your kidneys may cause kidney failure. Symptoms include:

• Urinating less than usual.
• Blood in the urine.
• Lower back pain.
• A blood clot in the lung

CAUSES & RISK FACTORS

What causes hypercoagulation?

 Some people may not have enough of the proteins that regulate blood clotting. This causes their blood to clot too often. Others may have the proteins but have issues with them not working right. Still others are born with a tendency to develop clots. This means it runs in the family.

Certain situations or risk factors can make it more likely for your blood to clot too much. These situations include the following:

• 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)
• Smoking

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 several unexplained miscarriages

DIAGNOSIS & TESTS

How is hypercoagulation diagnosed? If your healthcare provider suspects you have hypercoagulation, they may do a physical exam.  Your healthcare provider may ask if anyone in your family has or had problems with clotting.  They also can order blood tests to check the protein and platelet levels in your blood. The tests can also show if your proteins are working the way they should.

PREVENTION

Can hypercoagulation be prevented or avoided?

There is nothing you can do to prevent hypercoagulation if it’s inherited (runs in your family). However, there are some things you can do to reduce your risk if it isn’t inherited.

• Quit smoking.
• Maintain a healthy weight.
• Avoid medicines that contain the female hormone estrogen (such as birth control pills).
• Stay active during long trips. If traveling by car, take frequent breaks to get out and walk. If traveling by plane, walk up and down the aisles every hour. These activities will keep the blood flowing.
• Treat conditions that could lead to excessive clotting, such as diabetes.

TREATMENT

Hypercoagulation treatment

Hypercoagulation is usually treated with medicine. Most of the time, this medicine is called an anticoagulant. This is sometimes called a blood thinner. Some drug names you may hear are heparin, warfarin, dabigatran, apixaban, rivoraxaban, and aspirin. This medicine makes it hard for blood clots to form. It also can keep existing clots from growing bigger.

Some people only need to this medicine when they’re in situations that make them more likely to form clots. This can include during long car or airplane trips, when they’re pregnant, or when they’re recovering from surgery in the hospital. Other people need to take medicine on a regular basis for the rest of their lives. Your healthcare provider will decide what treatment is right for you.

If your healthcare provider prescribes an anticoagulant, you should:

• Follow their instructions carefully. This includes how, when, and how much of the medicine to take. It also includes getting follow-up blood tests so your healthcare provider can see how the medicine is working.
• Discuss your diet with your healthcare provider 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.
• Don’t take aspirin with other blood thinners unless your healthcare provider tells you it’s okay. Aspirin also can thin your blood.
• Talk with your healthcare provider 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.
• If you have other healthcare providers, tell them you’re taking an anticoagulant.
• Tell your healthcare provider right away if you’re pregnant or become pregnant. Some anticoagulants can cause birth defects.
• Tell your family you take anticoagulant medicine.
• Carry an emergency medical ID card with you at all times.

Anticoagulants can have side effects. Some can cause you to bleed easily. For example, if you cut yourself, it might take your blood longer than usual to clot. You might also bruise more easily. Contact your healthcare provider right away if you have bleeding that’s unusual or heavy.

Living with hypercoagulation

Hypercoagulation can be extremely dangerous. A blood clot inside a blood vessel can travel in the bloodstream.  It can get stuck inside one of your body’s organs. A clot that gets stuck in your lungs 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 people to have miscarriages. All of these conditions can also be life-threatening. That’s why it’s so important for hypercoagulation to be treated right away.