Hemostasis refers to the complicated chemical interplay that maintains blood viscosity, or thickness. Blood disorders occur when hemostasis falls out of balance. If blood becomes too thin, it loses the ability to form the blood clots that stop bleeding. When blood becomes too thick, the risk of blood clots developing within the blood vessels rises creating a potentially life-threatening condition. Hemostasis is achieved when blood chemicals, hormones and proteins are correctly balanced.
Blood Coagulation and Hemostasis: A Delicate Balance
Most people think of blood in its liquid state, but its ability to thicken into a blood clot is a vital part of the body’s natural defense. Over twenty different protein factors are required for a blood clot to form at a site of injury. This process of forming a clot is referred to as coagulation. Further chemical interactions are required to dissolve the blood clot as the body heals. A shift in hemostasis can result in coagulation that is either too slow or dangerously fast. Proper hemostasis results in normal blood coagulation.
Blood Disorders and Hemostasis
Blood disorders result from imbalances in hemostasis. Genetic blood disorders alter protein and chemical levels in the blood, making bleeding or clotting more common. Of the bleeding disorders, hemophilia is the most famous, although not the most common. Von Willebrand’s disease is actually the most common of the genetic bleeding disorders, and is caused by incorrectly functioning platelet cells.
Certain blood coagulation disorders increase the risk of developing blood clots in the blood vessels. Deficiencies in protein S, protein C, antithrombin III, or factor V Leiden can all result in the formation of blood clots. When a clot forms in blood vessels, it stops the flow of blood. If this occurs in a vital organ such as the heart, lungs or brain, the clot can be fatal.
Whether a blood disorder shifts hemostasis towards insufficient or excessive blood coagulation, patients need to inform their doctors and dentists of the situation. Surgery or dental work can be seriously complicated by blood disorders. In fact, for people with a blood disorder that affects hemostasis, wearing a medical alert bracelet or necklace describing the condition can be a lifesaver.
Factors that Upset Hemostasis
Not all of the factors that upset hemostasis are internal disorders. Medications such as aspirin and NSAIDs thin the blood and can impair blood coagulation. On the other hand, hormone therapy, used to treat menopause symptoms or to prevent pregnancy, increases a woman’s risk of developing a deep vein thrombosis. Certain diseases, most notably cancer and irritable bowel disease, can also alter hemostasis. Even pregnancy can alter a woman’s hemostasis, particularly if she already has blood disorders.