What is the impact of blood clotting?

Blood clotting is a complex and obscure biochemical and hemostatic process triggered when the blood circulatory system is damaged. When this happens, blood plasma turns into a jelly-like clog that plugs the wound and stops bleeding. Birth defects related to this, such as hemophilia, carry the inherent danger of bleeding inside joints as well as prolonged bleeding.

The acquired defects can lead to thrombosis, disseminated intravascular coagulation (DIC) syndrome and often can be fatal. In many cases, the inability of the blood coagulation system to keep the balance between blood liquid and solids becomes the cause of death from cancer, sepsis, trauma, atherosclerosis, heart attack, or stroke. Only in the last decade, scientists have learned how to diagnose coagulation issues through highly technological tests.

Who should have the coagulation test?

Pregnant women should always do it, but it is even better to have this test when planning for motherhood.

Those who plan to have a larger surgery if they had blood clotting before or are hereditary prone to it.

Before prescribing medicines that can increase the risk of developing blood clots. For example, it should be done before prescribing hormonal contraceptives, especially to women who are smokers. Although it doesn't happen frequently, this complication is dangerous. For this reason, many gynecologists run a comprehensive blood coagulation test before prescribing hormonal contraceptives.

Those who demonstrate symptoms prompting the venous thrombosis.

What does it include?

Coagulogram is the first stage of coagulation system screening. If it reveals deviation from the norm, the hematologist will send the patient for a detailed medical test.

Thromboelastography is the most informative test and evaluates several components of the blood coagulation chain. It is a detailed test of blood clot formation and dissolution.

Thromboelastometry is an even more informative test but is not currently administered in every hospital.

D-Dimer is a breakdown product of fibrin, a small fragment of a protein present in the blood after the destruction of a blood clot. A D-dimer test is administered when there is a risk of developing blood clots. Individuals who have an even slightly elevated level of D-dimer bear a higher risk of developing blood clots. It is advisable to control the level of D-dimer in the presence of vein diseases (thrombophlebitis), after surgery, and when patients leave the hospital after being bedridden for a long period of time. It is also necessary to control the level of D-dimer during pregnancy and when taking hormonal contraceptives. Currently, it is also required when diagnosed with COVID-19 and after recovery.

According to statistical data, more than 1–3 % of the world's population have congenital pathology of the blood coagulation system.

Genetic tests for congenital bleeding disorders accompany D-dimer tests in cases when the causes of thrombosis are not clear and when patients develop early thrombosis.

Atrial problem

Arrhythmia affected by atrial fibrillation can be another cause of elevated blood clotting. According to statistics, 2 % of the world's population over 30 years old suffer from a paroxysmal or permanent form of atrial fibrillation.

The deviation is caused by the occurrence of pathological electrical impulse swirls in the atria. The situation gets worse in cases when patients already had issues with coagulation. Blood clots can develop 48 hours after a heart attack and get into the brain arteries, arteries of extremities, or the gut.

COVID-19 and von Willebrand factor

Developing a severe form of COVID-19 can be related to an elevated level of one of the blood coagulation factors known as the von Willebrand factor. It has been proven that COVID-19 can damage the inner wall of blood vessels. The body tries to mitigate the damage due to the von Willebrand factor, which participates in activating platelets and essentially triggers the process of local blood clotting.

Timely prevention of thrombosis (by regular intake of anticoagulants, excluding certain foods and medicines, wearing compression hosiery during air travel and standing for extended periods of time, etc.) significantly decreases the risk of developing dangerous conditions.

14 August 2021