Coagulopathy: Signs, Causes, Treatment, and More Explained

Medically Reviewed By Alana Biggers, M.D., MPH
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Coagulopathy is an impairment in the blood’s ability to clot, leading to prolonged or excessive bleeding. Some coagulopathies are primary medical conditions, but they can also be a complication of other health conditions. Bleeding may occur after an injury to part of the body. Blood cells will form clots to stop bleeding and prevent excessive blood loss. The body will later break down this clot once the injury has healed.

The blood’s clotting process depends on various proteins and cells in the blood. Coagulopathy may result from the reduction or absence of blood-clotting proteins, known as clotting or coagulation factors.

Coagulopathy can cause uncontrolled internal or external bleeding. This can further cause damage to joints, muscles, or internal organs. Uncontrolled bleeding can be life threatening.

This article will explain coagulopathy, including its signs and symptoms, causes, treatment, and more.

What is the definition of coagulopathy?

A close-up of a child putting a band-aid on their bleeding knee.
timsa/Getty Images

Clinicians describe coagulopathy as an impaired blood clotting function. It can happen for various reasons, and different types of coagulopathies can occur.

Examples of coagulopathies include:

  • Hemorrhage: Hemorrhage is the significant loss of blood from a blood vessel. Blood vessels are the structures that transport blood around the body to the tissues and organs. They include arteries, veins, and capillaries. A hemorrhage can occur internally or externally and results from injury to the blood vessels.
  • Consumptive coagulopathy: Clinicians may also refer to this as disseminated intravascular coagulation. With this condition, the clotting process consumes clotting proteins and can trap platelets, leading to excessive bleeding.

What are the signs and symptoms of coagulopathy?

Symptoms of coagulopathy can vary depending on where the bleeding affects. Some symptoms include:

  • excessive bleeding that can occur spontaneously or following an injury, surgery, or other trauma
  • difficulty stopping bleeding or bleeding that takes a long time to improve
  • symptoms of bleeding into the joints, such as:
    • swelling, pain, or heat in the joints
    • involvement of the knees, elbows, or ankles
    • reduced range of motion, pain, or stiffness when moving
  • hematoma, or bleeding into the skin
  • bleeding in the mouth or gums
  • bleeding after receiving an injection
  • nosebleeds that may be frequent or difficult to stop
  • low iron levels or treatment for anemia
  • symptoms of a bleeding condition and at least one family member with a bleeding disorder diagnosis

When should you seek medical help?

In some cases, coagulopathy can cause bleeding in your brain or internal organs. This can be life threatening and constitute a medical emergency. 

Seek prompt medical help for symptoms of bleeding that do not improve.

Seek emergency treatment or call 911 for the following symptoms

The following symptoms can indicate life threatening conditions such as internal bleeding.

Seek immediate medical care for anyone experiencing the following symptoms:

  • hematuria, which is bloody or pink-colored urine
  • bloody stool, or stool that looks red, black, or tarry in texture
  • loss of consciousness or changes in consciousness, even if for a brief moment
  • convulsions or seizures
  • difficulty moving and speaking
  • loss of coordination or balance
  • partial paralysis or tingling and weakness of extremities
  • memory loss or confusion
  • loss of vision or changes in vision
  • a stiff neck or severe headache
  • repeated vomiting
  • symptoms of internal bleeding, such as:
    • pain, tenderness, or swelling in a certain area or extremity
    • bleeding from orifices, such as the mouth, vagina, or rectum
    • coughing up blood or bloody mucus
    • vomiting blood or fluid that looks like dark coffee grounds
    • tender, rigid, or bloated abdomen

What causes coagulopathy?

Blood clotting requires a certain amount of platelets and clotting factors.  Coagulopathy occurs due to low levels of one or more of these proteins. It also may occur when platelet levels are low.

Some genetic disorders, such as hemophilia and von Willebrand’s disease, can reduce clotting factors.

Genetic differences, deficiencies, or mutations can cause different types of coagulation disorders. Biological parents can pass down these mutations. In some cases, they can also occur after birth.

Other underlying conditions and factors can also affect the body’s blood-clotting ability. Clots in some places can impede platelets and clotting factors. Therefore, conditions that increase clotting behavior, known as hypercoagulation, can also lead to coagulopathy. 

Some additional conditions that may impair blood clotting include:

  • anticoagulant or blood-thinning medication
  • some blood cancers, such as leukemia
  • long-term use of antibiotics
  • liver disease, such as cirrhosis
  • infection
  • vitamin K deficiency
  • hereditary hemorrhagic telangiectasia, a condition in which blood vessels entangle, causing bleeding
  • thrombocytopenia, low platelet count
  • trauma or injury

What are the risk factors for coagulopathy?

Several factors increase the risk of developing coagulopathy. However, not all people who experience risk factors will develop coagulopathy.

Risk factors for some coagulopathies can include:

  • blood type
  • male sex (assigned at birth), in the case of hemophilia
  • a family history of a coagulopathy disorder

How is coagulopathy treated?

A doctor can order blood tests to determine the presence of coagulopathy and its underlying cause.

If you have coagulopathy, treatment options include medications or replacement therapy. In acute cases, emergency treatment may also be necessary to prevent serious blood loss or internal bleeding.

In replacement therapy, clinicians replace reduced or absent clotting factors with clotting factor concentrates. Researchers derive these concentrates from human blood or create them in a laboratory. This therapy may treat active bleeding or prevent bleeding from occurring.

Coagulopathy treatment aims to improve the blood’s ability to clot. However, the specific treatment largely depends on the underlying cause. Therapy may include replacing the clotting factors or increasing platelet levels through transfusion.

Medications for treating coagulopathy

When appropriate, your doctor may prescribe one or more of the following medications to treat coagulopathy:

  • Epsilon amino caproic acid (Amicar): This medication prevents blood clots from breaking down. It may also limit bleeding in the mouth during dental procedures.
  • Desmopressin acetate (DDVAP, Stimate): This medication can release the body’s blood-clotting proteins in cases of mild to moderate coagulopathy.
  • Clotting factor concentrates: These concentrates replace the body’s natural clotting factors. The two types are plasma-derived factor concentrates and recombinant factor concentrates.
  • Clotting medications: These medications, such as cryoprecipitate, can help manage serious bleeding.
  • Oral contraceptive pills: Birth control pills may help control excessive menstrual bleeding in people with coagulopathies.

What are the potential complications of coagulopathy?

Prompt treatment when bleeding begins is important to prevent or limit further damage. Without treatment, some complications of coagulopathy can be serious or life threatening.

You can help minimize your risk of serious complications by following the treatment plan your doctor will work with you to create.

Complications of coagulopathy can include:

  • anemia
  • internal bleeding and associated complications, such as:
  • blood loss
  • pseudotumors, which can put pressure on the surrounding tissues
  • fractures
  • bloodborne infections

Other frequently asked questions

Below are some frequently asked questions about coagulopathies.

What does “pathy” mean in medical terms?

“Pathy” comes from the Greek word for “suffering” and denotes relation to disease. For example, coagulopathy refers to diseases of the coagulation process.

Is coagulopathy the same as hemophilia?

Coagulopathy does not always refer to hemophilia. Instead, hemophilia is just one type of coagulopathy.

Other coagulopathies include von Willebrand’s disease and thrombocytopenia.

How does liver disease cause coagulopathy?

The liver produces most clotting factors that enter the blood.  Damage to the liver can thus impair or inhibit clotting factors.

Without an appropriate level of clotting factors, the blood will not clot, and excessive bleeding can occur. For example, cirrhosis coagulopathy can occur as scarring affects the liver’s function.

Is coagulopathy life threatening?

In some severe cases, coagulopathy and blood impairment complications can be life threatening.

However, treatment can help protect against complications and reduce the impact of the condition.

Summary

Coagulopathy refers to an impairment in the blood’s ability to clot. This may result from low levels of functional clotting factors, which help form clots that stop excessive bleeding. As a result, coagulopathy can cause symptoms such as excessive or spontaneous bleeding.

Coagulopathy can be serious. Some symptoms and complications, such as internal bleeding, can be life threatening. Seek emergency medical treatment for symptoms of confusion, severe pain, blood in the stool or vomit, or other signs of internal bleeding.

Treatment for coagulopathies includes medications and replacement therapies that help restore the blood’s clotting factors. This can help improve the outlook and address possible complications.

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Medical Reviewer: Alana Biggers, M.D., MPH
Last Review Date: 2022 Jul 11
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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