How Is Excessive Blood Clotting Diagnosed?
If your doctor thinks that you have excessive blood
clotting based on your signs and symptoms, he or
she will look for the cause of the condition.
Your doctor will ask about your medical and family
histories and review the results from a physical exam and tests.
Your primary care doctor may refer you to a
hematologist. This is a doctor who is an expert on blood diseases.
Medical and Family Histories
Your doctor may ask you detailed questions about
your medical history and your family's medical history. He or she may ask
whether you or a blood relative:
- Has a history of excessive or abnormal blood
clots before age 40 or had a
heart
attack or
stroke before age 50
- Has had blood clots during pregnancy or while on
birth control pills
- Has had unexplained miscarriages
- Has a history of excessive or unusual blood clots
(such as clots in the veins in the liver or kidneys)
Physical Exam
Your doctor will do a physical exam to see how
severe your blood clotting problem is and to look for its possible causes.
Diagnostic Tests and Procedures
Your doctor may order
blood
tests to look at your blood cells and the clotting process. If he or she
thinks you may have a genetic condition, you may need more blood tests.
Tests to find the cause of excessive blood clotting
may be delayed for weeks or even months while you receive treatment for a
problem blood clot.
Complete Blood Count and Platelet Count
An initial blood test will include a complete blood
count and a platelet count. These tests measure the number of red and white
blood cells and platelets in your blood.
In this situation, your doctor will want to know the
number of platelets in your blood. Platelets are blood cell fragments that
stick together to form clots.
Tests for Clotting Factors and Clotting Time
You also may need blood tests that look at the
proteins active in the blood clotting process and how long it takes them to
form a blood clot.
Clotting proteins or factors react with each other
along two pathways called the intrinsic and extrinsic pathways. (A pathway is a
string of chemical reactions that always occur in a certain order.) The two
pathways join in a common pathway to make a fibrin network that holds blood
clots together.
- PT test. This test looks at the extrinsic and
common pathways to measure how long it takes blood clots to form. People who
have excessive blood clotting may take the medicine warfarin to prolong their
clotting times.
- A PTT test. This test looks at the intrinsic and
common pathways to measure how long it takes blood clots to form. People also
may take blood thinners, like heparin, to slow their clotting times.
Followup Tests
If your doctor thinks your blood clotting condition
is genetic, you may need other blood tests. These may include tests that
check:
- For gene mutations that can cause excessive blood
clotting
- For antibodies related to
antiphospholipid antibody syndromea
cause of excessive blood clotting
- Your homocysteine levels (if you're at risk for
vascular disease)
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