Coagulopathy
Impaired blood clotting causing prolonged or excessive bleeding.
Coagulopathy, also called a bleeding disorder, is a condition in which the blood's ability to form clots is impaired. This leads to a tendency toward prolonged or excessive bleeding, which may occur spontaneously or after injury or medical procedures. It is distinct from a clotting disorder, which involves excessive clot formation.
Signs and symptoms
Coagulopathy can result in uncontrolled internal or external bleeding. Without treatment, such bleeding may damage joints, muscles, or internal organs and become life-threatening. Serious symptoms requiring immediate medical attention include heavy external bleeding, blood in urine or stool, double vision, severe head or neck pain, repeated vomiting, difficulty walking, convulsions, or seizures. Prompt care is also needed for mild but unstoppable external bleeding or joint swelling and stiffness.
Mechanism
Normal clotting depends on the interplay of various blood proteins. Coagulopathy may arise from reduced levels or absence of clotting factors, as seen in genetic disorders like hemophilia and Von Willebrand disease. Anticoagulants such as warfarin can also prevent proper clot formation. Additionally, dysfunction or reduced levels of platelets, the small disk-shaped bodies that aid clotting, may cause coagulopathy.
Treatment
Healthcare providers may manage coagulopathy with medications or replacement therapy, where missing clotting factors are replaced using proteins from human blood or laboratory creation. This therapy can treat active bleeding or prevent future bleeding. In critical settings like an emergency department, major bleeding is often managed by transfusing red cells combined with blood plasma, prothrombin complex concentrate with factor XIII and fibrinogen, or fibrinogen with tranexamic acid. Tranexamic acid is the only option supported by a large randomized controlled trial and is given after trauma. Risks of treatment include transfusion-related acute lung injury, acute respiratory distress syndrome, multiple organ dysfunction syndrome, major hemorrhage, and venous thromboembolism.
More in Bleeding
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced