What is thrombophilia?

Thrombophilia, also called hypercoagulability or prothrombotic state, means 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 the blood clot. Forming a clot is called “coagulation”. Coagulation is a natural, life saving mechanism when you are injured and bleeding because it slows blood loss. However, your blood should not clot when it’s just trying to move through your body.  If blood clots inside your blood vessels, it is called “thrombosis” – it can either partially or completely block the flow of blood in the vessel. The tendency to clot too much is called hypercoagulability or "thrombophilia."

Why is thrombophilia dangerous?

When abnormal clotting occurs inside the blood vessel, it can slow or stop the flow of blood from (for veins) or to (for arteries) the arm, leg, or other area of the body that it normally drains/supplies.  A clot inside a blood vessel is called a "thrombus".  Sometimes the thrombus can break loose from its original location, travel through the bloodstream and lodge in a vessel in your lungs.  This kind of a clot is called a "pulmonary embolus", and can result in difficulty breathing and strain on the heart, and can be life-threatening.  Blood clots can cause at risk women to have miscarriages.  A clot that blocks a blood vessel in the brain can cause a stroke and a clot in an artery providing blood flow to your heart muscle can cause a heart attack.

Am I at risk for a clot?

There are several factors, called risk factors, that increase your chances of developing a dangerous clot. Usually, more than one of the risks factors needs to be present to form a clot. 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 inflammation (sever infection, lupus) c vvx
• The blood flow through your veins is slowed due to a prolonged state of decreased activity or mobility (as with long car, bus, train or airplane rides; 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.

How do I know if I have a clot?

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 is the veins orarteries of the brain often cause sever headache, sudden one-sided weakness, blurred vision, or difficulty speaking. Sometimes, clots (especially in other areas of the body) may cause no symptoms.

Can thrombophilia be treated?

There are medicines that can thin your blood and make it less likely to 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 medicine for the rest of their lives.

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 comes in two main forms and if you are in the hospital, you may get your heparin through an IV. You may go home on heparin that 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 coumadin is working in your blood. Warfarin's effectiveness can be affected by antibiotics, infections, and changes in diet.

These medications can cause you to bleed more easily. 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, avoidance of contact sports; helmet use while riding a bike; diligent use of seatbelts in motor vehicles). If you have any unusual bleeding, call your doctor right away.

What can I do to help avoid a clot?
• Consult your physician if you have a personal or family history of 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 (consult physician).
• Exercise regularly (walking, jogging, swimming...) and keep your weight at a normal level.
• Avoid smoking
• Avoid excessive alcohol
• Keep well hydrated
• Check your cholesterol regularly
• Consult your physician when you have an infection and are on warfarin.