Blood Clotting Disorders

A blood clotting disorder (also called a hypercoagulable state or thrombophilia) makes your blood form clots too easily and sometimes when it shouldn’t. This means blood clots can form in your veins or arteries and possibly travel through your bloodstream, leading to problems like pulmonary embolism (PE), heart attack and stroke.

At Cleveland Clinic, we know how serious blood clotting disorders can be and we’re dedicated to reducing the impact of these conditions on your life. We diagnose and treat a wide range of blood clotting disorders, including those you’re born with (inherited) and those you develop later on (acquired).

Types of blood clotting disorders

There are many types of blood clotting disorders. Some are inherited, like:

• Factor V Leiden.
• Prothrombin gene mutation.
• Deficiencies of proteins that prevent clotting, such as antithrombin, protein C and protein S.
• High levels of proteins that promote clotting, such as fibrinogen.
• Abnormal fibrinolytic system (which breaks down blood clots after they’ve formed).

And some are acquired, like:

• Antiphospholipid syndrome (APS).
• Disseminated intravascular coagulation (DIC).
• Paroxysmal nocturnal hemoglobinuria (PNH).

You can also develop other acquired blood clotting disorders from:

• Oral contraceptives or hormone replacement therapy.
• Certain medical conditions, like cancer.
• Not being able to move your body for long periods of time.

What to expect at your first visit

This is our chance to get to know you and find out what brought you here. We’ll spend some time talking about your medical history, including any conditions you have and whether you’ve had blood clots in the past. We’ll also want to know if any of your biological family members have a history of blood clots. Some types of blood clotting disorders run in families, so this information can help us learn more about your risk.

Then, we’ll do a physical exam to check your vital signs and learn more about your overall health. We’ll also decide which tests you might need to help us make a diagnosis. Possible tests include:

• Blood tests. Blood tests help us diagnose or rule out certain blood clotting disorders. Many different components of your blood provide clues. For example, we can check the levels of certain proteins (like fibrinogen) that make your blood clot. Higher-than-normal levels of fibrinogen may point to a blood clotting disorder.
• Genetic testing. In addition to looking at the tiny parts of your blood that make it clot, we may look for changes in your genes, chromosomes and proteins. Some changes can show if you have an inherited condition that makes your blood more likely to clot.
• Imaging tests. If we need to get a closer look at specific areas inside your body, we’ll do tests like X-rays, ultrasounds or CT scans.

We’ll use all the information we gather to diagnose or rule out specific blood clotting disorders. Depending on what we find, we’ll create a treatment plan tailored to your needs.

Meet Our Blood Clotting Disorders Team

Your Cleveland Clinic team will include experts from many different specialties, all working together to make sure you get outstanding care. Your team may include:

• Vascular medicine specialists.
• Cardiologists.
• Cardiovascular surgeons.
• Vascular surgeons.
• Hematologists.
• Radiologists.
• Anesthesiologists.
• Pathologists.
• Genetic counselors.

Finding out you have a blood clotting disorder can be unnerving. But rest assured, our specialists are ready to dive in and take the necessary steps to keep you healthy.

The best treatment plan for you depends on your current situation. For example, we’ll take a different approach for someone who has blood clots in their body versus someone who has a blood clotting disorder but no active clots. Possible treatments include:

• Medications. Anticoagulants are medications that prevent your blood from clotting too easily. We may prescribe them for you to take at home, or we may give them to you through an IV (in a vein in your arm) or injection in the hospital.
• Thrombolytic therapy. We use “clot-busting drugs” to dissolve clots in certain emergency situations.
• Compression therapy. Gentle pressure (compression) on certain parts of your body, like your legs, can improve symptoms of deep vein thrombosis (DVT) or prevent new blood clots from forming. For example, we might recommend you wear compression stockings at home. Or, we might use a compression device when you’re in the hospital to prevent DVT.
• Vena cava filter placement. If you can’t safely take anticoagulants or these medications aren’t doing enough to help, you may need a procedure to put in a vena cava filter. This is a small metal device that prevents blood clots from reaching your lungs.
• Blood clot removal (embolectomy). We can remove blood clots that moved to various parts of your body, including your lungs. We’ll use traditional surgery or catheter-based methods depending on the size of the clot. Usually, embolectomy is a last resort when medications aren’t helping, or you can’t take them for some reason.

If you haven’t had a blood clot before and don’t have one at this time, you may not need medications or other treatments right now. Instead, we’ll talk about what you can do to prevent a clot from developing. Together, we’ll come up with a plan to help you:

• Add more exercise to your daily routine.
• Reach and keep a weight that’s healthy for you.
• Avoid tobacco products.
• Lower your risk of blood clots during long flights or road trips.

Taking the Next Step

It’s normal to worry what the future will bring and how a blood clotting disorder might impact your life. There are plenty of unknowns with any condition, but one thing is certain. We’re ready to give you the best possible care. Let our team guide you forward as you get answers to your questions and learn more about what’s going on inside your body. Through it all, we’ll be by your side.