Blood clotting also known as coagulation prevents excessive bleeding from taking place when a blood vessel is injured. Coagulation is a complex process that involves a cellular and a protein component. The blood clotting process involves blood changing from a liquid to a solid. This process involves 20 different plasma proteins which are known as the clotting factors. If these factors are deficient or missing this process will not happen normally and many things may or will go wrong in the coagulation process.
There are many participants to the complex process of coagulation, one of those being platelets which are also known as thrombocytes. These cells are small, irregularly shaped and have a life span of five to nine days. These cells circulate through the blood of mammals and are involved in hemostasis. In hemostasis, a damaged blood vessel wall is plugged by a platelet and a fibrin containing clot to stop bleeding so the damage to the blood vessel may be repaired and healing may occur.
Fibrin is an insoluble protein involved in blood clotting which deposits around the wound forming a mesh like substance that strengthens the platelets plug. The platelets and the proteins in the plasma, work together to stop the bleeding by forming a clot over the injury; which the body will then dissolve after the injury is healed. The coagulation factors are proteins mostly manufactured by the liver. When a blood vessel wall is damaged, a wound occurs, and a complex set of chemical reactions occur and convert it to fibrinogen.
In people with bleeding disorders, the clotting factors are missing or do not work properly. Some bleeding disorders are genetic and quite rare. Some examples of bleeding disorders are Von Willebrand disease, liver disease, antibodies produced by the immune system, medications such as aspirin or warfarin or hemophilia. With Von Willebrand, patients typically have low levels of the clotting factor VIII, which usually is mild and with early diagnosis usually have no real concerns for excessive bleeding unless they are having surgery but medications may be given to counteract this.
Another bleeding disorder that revolves around factor VIII, is hemophilia A, which is an inherited bleeding disorder where this factor is usually missing or in low levels and the blood will not clot like it does normally which does make a person at risk for bleeding. Liver disease is a common cause of blood clotting dysfunction since the liver makes six of the blood clotting factors; factor I (fibrinogen), factor II (prothrombin), factor IV, factor V, factor VI and factor VII. Furthermore, if a patient has a deficient level of factor VIII this would be diagnosed as hemophilia A.
If a patient has different levels of factor IX then this would be diagnosed as hemophilia B. On the opposite end of blood clotting, there are some patients that have an increased tendency to form excessive clots. These conditions are typically inherited; Factor V Leiden and thrombophilia are two examples of what happens when there is an abnormality in a particular clotting factor. Factor V Leiden Thrombophilia is a topic of special interest to me since I have an Aunt on my mother’s side that was confirmed to have this certain genetic clotting disorder.
Factor V Leiden thrombophilia is an inherited disorder for a specific gene mutation that results in thrombophilia. Thrombophilia is an increased tendency to form abnormal blood clots that can block blood vessels. People with Factor V Leiden thrombophilia have a higher than average risk of developing a type of blood clot called a deep venous thrombosis (DVT). My Aunt did have some issues with each pregnancy but overall she was healthy and her babies were healthy. The last baby landed her back in the hospital a couple days after delivery with severe headaches and not feeling well.
She was diagnosed with eclampsia and had several abnormal liver and kidney function tests for several months after her hospitalization. However, it was not until my Aunt was in her forties and had major surgery and suffered a DVT that physicians decided to investigate further. After having the full genetic test for Factor V Leiden completed as well as some complement testing the physicians confirmed that she did indeed had this disorder. My Aunt did have to go on anti-coagulant therapy which included Lovenox injections initially and later Warfarin for a short time but after eleven years she no longer has to be on any anti-coagulant.
She follows a healthy diet and an exercise program which includes the addition of a daily folic acid supplement and quarterly visits to the hematologist. Fortunately for her and many people with this inherited disorder they do get to live a normal life and many never have any complications or even know of their condition. I know when my Aunt travels for more than two hours on an airplane she will be placed on anti-coagulants prior to the flight, during, and following her trip; but that is much better than her life being taken away.
If a person indeed develops a blood clot this is known as thrombosis. These clots are caused an excessive number of platelets and may lead to a stroke, myocardial infarction or pulmonary embolism. There are many risk factors for developing a venous or an arterial clot, these risk factors may cause unnatural clotting. For example, obesity and pregnancy will increase the risk factors for a venous clot especially if a person has a genetic condition such as Factor V Leiden.
Furthermore, smoking, oral contraceptives and chronic inflammatory disease may also increase a person’s risk for venous blood clots. However, the risk factors for arterial blood clots are obesity, smoking, diabetes, high blood pressure and high cholesterol which may be altered by lifestyle modifications which would dramatically reduce the risk for clots. DVT’s are blood clots deeply embedded in deep veins of legs, thighs and pelvis. The clots block the circulation to the heart and cause pain in the area of the clot, and swelling and warmth in the affected vein.
Due to the complications that may arise due to the thrombophlebitis, the most dangerous side effect would be for the clot to break off and move through the blood stream. This may lead to blockage of the blood vessels in the lungs which may lead to a pulmonary embolism which may lead to severe difficulty in breathing and possibly death. This particular disorder, DVT’s that arise from a blood clot statistically affects close to two million people per year, resulting in approximately six hundred and fifty thousand deaths.
More awareness due to these statistics is reaching the public because there are many factors that do make your risks increase as well as decrease with prevention. Some of these risk factors include recent childbirth, genetic defects of the clotting factors, immobility, advanced age, and estrogen replacement therapy or oral contraceptives. One of the common themes in the risk factors is the relationship to women, and how as women we need to be aware of all of our risk factors whether genetic, lifestyle, or caused in relation to various types of hormones.
In conclusion, the ability for our bodies to clot blood is an amazing process. Coagulation is quite complex and intricate at the same time. Many of the reasons we may develop a thrombosis are of no control of our own and we would also have no clue to know we are at risk for a clot or that our bodies clotting factors did not work properly. The good news regarding the unknown is all the risk factors we do know that may increase your risk for blood clots. We have also learned many techniques for prevention of blood clots.
For example, getting regular exercise is something we all should do on a regular basis whether or not we have thrombophilia. Also, it is important to note if we are on the other end of the spectrum as in the case with bleeding disorders, most cases with early detection you do not bleed to death like most people believe in cases of hemophilia. Our bodies throughout are a system of checks and balances, forming something off another process; and unfortunately if anything is missing or the numbers are deficient such as the clotting factors our bodies will not function normally.
This malfunction as discussed earlier may lead to a variety of disorders such as bleeding disorders or clotting disorders. It is important to know the risk factors and what we all can do to help prevent anything more serious happening such as a DVT, stroke, or pulmonary embolism. Furthermore, as awareness reaches deeper into the community and our providers develop better screening tools more people will be accurately diagnosed early on before too much damage is done. After researching more into blood clotting and how our bodies work I have gained a full aspect as to why this class is important for my career.
For my future career I want to become a Registered Nurse and further more my career and become a Nurse Anesthetist. Anatomy and Physiology is a huge concept to understand if you are trying to go into any sort of medical field. Knowing how all the things in our body functions is a very important quality to learn. I feel that if someone does not have the essential knowledge of Anatomy and Physiology for their specific nursing career then they will only hurt themselves because it is a very important class to take for medical students.
If I was working as a nurse in an emergency room somewhere and someone came in with huge gashes all the way down their legs and it could not stop bleeding then I would have to be able to determine what to do. Having good background information to go on will only benefit me in the long run. In nursing school I will look back on taking this class and remember key information that I will only be using for a lifetime.
“All About Hemophilia / Haemophilia. ” Medical News Today. MediLexicon International, 30 Dec. 0031. Web. 09 Aug. 2012. <http://www. medicalnewstoday. com/info/hemophilia/what-is-coagulation. php>. “American Society of Hematology. ” Blood Clots. N. p. , n. d. Web. 07 Aug. 2012. <http://hematology. org/Patients/Blood-Disorders/Blood-Clots/5233. aspx>. “Deep Vein Thrombosis (Blood Clot in the Leg, DVT). ” WebMD. WebMD, n. d. Web. 07 Aug. 2012. <http://www. webmd. com/a-to-z-guides/deep-vein-thrombosis-blood-clot-legs>. N. p. , n. d. Web. 08 Aug. 2012. <http://www. hemophilia. org/NHFWeb/MainPgs/MainNHF. aspx? menuid=203>.