Coagulopathy – Definition, Causes, Symptoms, Treatment, Pictures

Coagulopathy Definition

Coagulopathy is an illness where there is an abnormality in the clotting process of the blood. The normal blood clotting process is important to prevent too much blood loss from the body after an injury. When a person accidentally cuts himself, the blood clots within two minutes. The blood solidifies and the clot is made. The blood clot serves as plug on the site of injury that prevents the gushing of the blood out of the body. This blood clotting process is made possible by the existence of adequate number of proteins in the blood such as the albumin, clotting factors, and the platelets. In coagulopathy, this normal process may be happening because of the low or high levels, or worst, absence of the blood protein, clotting factors, and platelets which results to uncontrolled massive bleeding.

 Coagulopathy Causes

Out of many blood disorders, there are causes that make the blood’s normal clotting process impaired:

Low levels of blood proteins and clotting factors

The blood proteins like the Albumin are the one that pulls the blood into and keep it from seeping out of the blood vessels while the clotting or coagulation factors and the platelets are the one that makes the blood clot. Once the clot is formed, it serves as a plug or filling on the opening (the area traumatized) so the blood won’t gush out of the body. Once these normal processes dysfunction, the person might suffer excessive blood loss that may lead to shock and possible death if not properly attended.

Intake of anti-coagulation medication

There are medications that impair the normal clotting process like the Heparin and the Warfarin.

Existing liver problems

All of the clotting factors except Factor VIII, megakaryocytes, and vonWillebrand’s Factor are made in the liver. If the liver is impaired and diseased, there are instances that the liver may produce few clotting factors, or worst, none.

Vitamin K deficiency

Vitamin K, or menaquinone, is a fat-soluble Vitamin produced by the liver that plays a big role on blood coagulation. It is an essential vitamin where proteins are dependent. Without the vitamin K, the coagulation proteins will not be active to form a clot. The Vitamin K is also found in food like green leafy vegetables, cauliflowers, and liver.

Underlying Genetic disorders

There are blood illnesses that such as Haemophilia, von WilleBrand’s disease, Factor II deficiency where the genetic make-up of the person’s blood is lacking of the important clotting or coagulation factors. These disorders are hereditary.

Coagulopathy Symptoms

1. Hypocoagulability

Uncontrolled bleeding externally

1. Bleeding through the mouth and gums
2. Bleeding through the anus, vagina, or penis
3. Frequent epistaxis or nose bleeding
4. Big rashes and hematomas
5. Easily bruised when bumped into something hard
6. Excessive and prolonged menstruation
7. Pallor

Uncontrolled bleeding internally

1. Joint bleeding – Painful, swelling, and reduced range of motion of the joint
2. Presence of blood in the urine or hematuria
3. Presence of blood in the stool (the color may be black or red, and tarry)
4. Bloated feeling
5. Increase in abdominal girth – possible bleeding in the gastrointestinal system

Cerebral Effects

1. Disorientation
2. Fainting, or Loss of consciousness
3. Seizures and Convulsions
4. Changes in vision or loss of it
5. Memory loss
6. Tingling sensation and weakness of the lower and upper extremities
7. Unbalanced gait and difficulty in walking
8. Speaking problems

Coagulopathy Pictures

Coagulopathy features on face

Coagulopathy Types

There are two types of Coagulopathy

1. Hypocoagulability

This is a condition of coagulopathy where there is an unusual uncontrolled bleeding.

2. Hypercoagulability or Thrombophilia

This is a condition where there is an increase in blood coagulation that results to thrombosis. These blood clots are possible to occlude the blood vessels and cause deep vein thrombosis, arterial thrombosis, and pulmonary embolism.

Coagulopathy Diagnosis

Coagulopathy are carefully diagnosed by qualified physician by undergoing test of coagulopathy

1. Bleeding Time – this is done to know the time (in seconds) the small blood vessels to close and stop the bleeding.
2. Complete Blood Count with Platelet– this is to know the quantity of Red Blood Cells, White Blood Cells, and Platelet counts.
3. Fibrinogen Level – this is done to measure the number of protein and clotting factor (Factor 1) that plays a role in blood clotting.
4. Hageman Factor Assay, Factor 5, Factor 7, Factor 8, and Factor 10 level – This is to know the measurement of the levels of the essential clotting factors important for blood clotting process.
5. Partial Thromboplastin Time (PTT) – is the blood test that measures the total clotting time per cycle.
6. Liver Function Test – these are liver examinations such as SGPT and SGOT to know if the liver is functioning and capable of producing the important substances and enzymes for body’s use.

Coagulopathy Treatment

Coagulopathy are treated carefully to avoid massive loss of blood that may be fatal to the person.

1. Medications such as Aminocaproic Acid that prevents the blood clots to break down, Birth Control contraceptives that help to control the excessive and prolonged menstruation, and Desmopressin Acetate to activate the stored blood-clotting proteins.
2. Blood and Plasma Infusion – to replace the blood loss.
3. Blood clotting Factor infusion – this depends to what genetic condition the person has and it is important for them to have this because this is what they are lacking. It is to be replenished to avoid uncontrolled bleeding.

Prevention

There is no total prevention for the coagulopathy to occur if the patient has underlying genetic disorder that leads to coagulopathy. To prevent the uncontrolled massive bleeding, the patient must avoid having himself traumatized even the lightest bump because his blood vessels are sensitive enough to bleed and there is no enough clotting factor to stop the bleeding. Also, if the trauma is inevitable, the patient should have enough supply of his medications as well as the infusion of clotting factors to avoid blood loss.