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What is excessive blood clotting and how is it treated?

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Pathologist and Microbiologist
Practicing since : 2006
Answered : 6980 Questions
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I would like to ask hematologist: What is the root cause of hypercoagulation and can it be treated so the condition goes away?

I had my first stroke on 5/1/2015. I have a history of a dozen lacunar strokes in different parts of my brain (sometimes in several places at once) and many TIAs over the past three years, for which I have received tPA , and after which the stroke symptoms resolved with minimal lasting deficits (left hip is still weak). Recently, I went to a hemotologist to see if I could find the cause of the strokes and TIAs. He did an extensive workup and told me my "blood protein is all screwed up". I assumed he meant fibrinogen. He diagnosed me with hypercoagulation and put me on lovenox shots for two weeks, then transitioned me to Coumadin six weeks ago. Since then, the strokes and TIAs have stopped.

My fibrinogen, antithrombin III, and D Dimer are elevated and my TEG Platelet Mapping shows hypercoagulation. My normal blood tests: Protein S, Protein C, Factor V Leiden, IGG/IGA/IGM, Anticardiolipin Antibody, Thrombin Time, Lupis Anticoagulant, DRVVT, Heparin Level, APPT, Protime-INR, PFA, Homocystein, Cortisol, C Reactive Protein, Tropinin I, Prothrombin DNA, PT, PTT.

I did some research and learned that elevated fibrinogen could be the result of chronic inflammation from atherosclerosis, which I have. Other causes might be cancer or arthritis, which I don’t have. Can you think of anything else that might be causing it and have you any ideas on how to reverse it permanently? I don't want to take Coumadin for the rest of my life if I can help it.

Mon, 11 Jun 2018 in Blood Disorders
 
 
Answered by Dr. Shailja Puri 8 hours later
Brief Answer:
Hypercoagulobale state can only be managed not treated all together

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Looking at your investigations and co-morbidities, the hypercoagulable state can be managed and not treated all together.
Hypertension and hyperlipidemia are important factors which increase the risk of hyper-coagulable state.
Keeping these two conditions under control is essential to improve quality of life.
However, I am afraid you may have to live on blood thinners like coamadin for rest of life.

Thanks and take care
Dr Shailja Puri
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