(PDF) Evaluation of Abnormal Bleeding in Children
Types And Causes Of Blood Clotting Disorders
Blood clotting disorders are inherited or acquired conditions that affect the body's ability to form blood clots. Some types of blood clotting disorders may cause excessive formation of blood clots, which can lead to stroke or heart attack—and other types cause too much bleeding, which can lead to bruising, blood loss, and liver damage.
The term coagulation disorder describes conditions that cause excessive blood clots or conditions that cause excessive bleeding.
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What Is a Blood Clotting Disorder? A blood clotting disorder is a condition that disrupts the healthy formation of blood clots. Blood clotting disorders include conditions that interfere with the body's ability to form blood clots or cause blood to clot too easily. Blood clotting helps your body heal from injuries. A blood clot is a temporary "plug" that forms over a cut or a wound—inside or outside the body. Healthy blood clots serve to stop the bleeding within a few minutes. The blood clot withers away as the body heals from the injury over several days or up to a few weeks. Types of Blood Clotting Disorders Blood clotting disorders involve disruptions in the way the body forms blood clots. These may include bleeding disorders, in which the blood doesn't clot as well as it should, and hypercoagulable disorders, in which there is an increased tendency to form blood clots. Both types of coagulation disorders can be dangerous. Bleeding can lead to blood loss, anemia (low red blood cells), and organ damage and may be life-threatening. Blood clots can interrupt blood flow, leading to irreversible or fatal organ damage. Treatment can often reduce the risk of having a serious health outcome from a blood disorder, but some treatments can cause an overcorrection—resulting in the reverse coagulation disorder. Hypercoagulable Disorders Hypercoagulable disorders cause the blood to clot excessively, potentially causing blockages of blood flow in the arteries or veins. Such blockages deprive the organs of oxygen and nutrients, leading to damage in the area of the body that isn't receiving proper blood flow—such as the heart, lungs, brain, or legs. Examples of hypercoagulable disorders include: Factor V Leiden thrombophilia mutation (an inherited disorder with a faulty blood clotting factor leading to an increased risk of blood clots) Prothrombin thrombophilia gene mutation (an inherited disorder with a faulty blood clotting factor leading to an increased risk of blood clots) Antiphospholipid antibody syndrome (an autoimmune disease in which the immune system produces antibodies that damage blood vessels and increase the risk of clots) Sickle cell disease (an inherited disorder in which the oxygen-carrying protein hemoglobin in red blood cells causes red blood cells to deform under low-oxygen conditions, block blood vessels, and activate coagulation) Inflammatory disease, such as systemic lupus erythematosus Cancer Shock, such as after a traumatic injury Disseminated intravascular coagulation (a disruption of blood clotting due to factors such as severe infection, trauma, or cancer) Bleeding Disorders Bleeding disorders are inherited disease diseases or acquired conditions that cause excessive bleeding due to insufficient blood clot formation. These conditions can cause blood loss. Examples of bleeding disorders include: Side effects of blood thinner treatment Liver failure (due to low clotting factor production in the liver) Vitamin K deficiency (a vitamin needed for making clotting factors) Hemophilia (a group of inherited bleeding disorders due to not producing some clotting factors) Von Willebrand disease (VWD) (a usually inherited disorder with a low or malfunctioning clotting factor) Causes and Risk Factors Some hypercoagulable disorders and bleeding disorders are hereditary, and some of these conditions can develop later in life. Risk factors include: Nutrient deficiency Cancer Liver disease Medication side effects, especially blood thinners or hormone therapy Septicemia (blood infection) Severe infection Inflammatory disease Bone fractures Major surgery If you have known risk factors, your healthcare providers may take special precautions or may prepare for complications. For example, you might have testing to determine your blood type in case you need a blood or blood product transfusion during or after a major surgical procedure. Symptoms Symptoms of blood clotting disorders can range from mild to severe and may develop gradually or suddenly—depending on their cause and severity. Symptoms of bleeding disorders can include: Frequent bruising, even after minor bumps Unexplained bruises Prolonged bruises Bleeding that soaks many bandages, even after minor cuts Heavy menstrual bleeding Symptoms of blood clots can include: Chest pain, which is a sign of a heart attack Shortness of breath, which can be a symptom of a heart attack or a pulmonary embolism (a blood clot lodged in the lung) Transient ischemic attack (TIA) symptoms, such as a few seconds of weakness or tingling on one side of the body, loss of one side of vision, slurred speech, or trouble walking Stroke, with weakness, sensory changes, speech disturbance, or vision changes lasting longer than a few seconds Blood Clotting Disorders and Pregnancy Bleeding disorders and hypercoagulable disorders can cause complications for the pregnant person and fetus during pregnancy, labor, and delivery. If you have a blood clotting disorder, it's important to discuss your plans to get pregnant with a healthcare provider so you can receive coordinated prenatal care, treatment for blood clotting during pregnancy, and a plan for labor and delivery. Diagnosing Blood Clotting Disorders Usually, the diagnosis of a blood clotting disorder involves blood tests and other diagnostic tests, such as imaging tests. Routine blood tests, such as a complete blood count (CBC), can detect anemia (low red blood cell count or function) or low platelets (cells active in blood clotting). However, CBC results alone can't diagnose a blood clotting disorder. Other specialized blood tests can help diagnose blood clotting disorders, and your healthcare provider may order one or more of these tests based on your symptoms and initial blood test results: Additionally, imaging tests are sometimes used to identify blood clots in the brain, lungs, heart, legs, or neck blood vessels. An electrocardiogram (EEG) or echocardiogram can help identify damage from blood clots in the heart. Brain imaging tests can help to identify a stroke. Treatment and Management Options If you're diagnosed with a blood clotting disorder, you can get treatment, and you may need certain considerations in managing your condition as well. The treatments for each different blood clotting condition are specific to that condition. Examples of treatment for some blood clotting conditions include: Hypercoagulable conditions: Medications to prevent stroke, heart attack, and blood clots include aspirin, coumadin, Plavix (clopidogrel), Xarelto (rivaroxaban), and others. Hemophilia: Blood transfusion or medication to increase red blood cell production can help replace low red blood cells. Blood clotting factor deficiency: Sometimes, blood clotting factors can be replaced. Autoimmune disorders: Anti-inflammatory therapies can lower the immune system function, preventing the immune system's effect on blood clotting factors. When to See a Provider Blood tests and other routine diagnostic screening tests can often help identify bleeding disorders or blood clotting disorders. So, keeping up with your recommended appointments is essential. Bleeding disorders can cause unusual bleeding or bruising. Blood clots can have serious health consequences, and some people might experience warning signs before a heart attack or stroke. You need to see a healthcare provider if you have any of the following signs or symptoms of coagulation disorders: Frequent bruising Unexplained bruises Prolonged bleeding from injuries Bleeding for more than a few seconds after minor cuts Bruises lasting for longer than a few days Your healthcare provider will talk to you about your symptoms and ask about your health history and family medical history. After you have a physical examination, your provider may order tests to help identify whether you have a bleeding disorder or a high risk of blood clots. When to Get Emergency Help Sometimes, blood clotting disorders can cause consequences that require prompt medical attention. Call for urgent help if you or someone else develops: Chest pain or shortness of breath with exertion Brief neurological symptoms, such as tingling, dizziness, or episodes of blurred vision Heavy bleeding that won't stop Feeling dizzy, lightheaded, or like you will pass out Loss of consciousness Summary Blood clotting disorders include disorders that cause you to bleed too easily and disorders that can make you prone to blood clots. Both of these issues can cause health complications. Symptoms of a bleeding disorder include bruises and bleeding. Specialized blood tests can often help identify blood clotting disorders, and treatment can often reduce the risk of serious consequences. Some blood clotting disorders are hereditary, and if you know of a blood clotting disorder that runs in your family, you might be able to get a diagnosis and start treatment before you experience any symptoms or complications. 10 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Jover Pinillos JL, Ferrandis Comes R, et al. Preoperative coagulation tests: a narrative review of current guidelines. Rev Esp Anestesiol Reanim (Engl Ed). 2024;71(10):740-747. Doi:10.1016/j.Redare.2024.09.005 National Heart, Lung, and Blood Institute. Blood clotting disorders: types. Centers for Disease Control and Prevention. Risk factors for blood clots. MedlinePlus. Factor V Leiden thrombophilia. MedlinePlus. Prothrombin thrombophilia. National Organization for Rare Disorders. Antiphospholipid syndrome. Centers for Disease Control and Prevention. Complications of SCD: blood clots. National Heart, Lung, and Blood Institute. Bleeding disorders; types. Bao R, Fan M, Hu M, et al. Risk factors and predictive model for disseminated intravascular coagulation in patients with multiple myeloma. Clin Appl Thromb Hemost. 2025;31:10760296251316873. Doi:10.1177/10760296251316873 Hoang T, Dowdy RAE. Review of inherited coagulation disorders. Anesth Prog. 2024;71(2):87-95. Doi:10.2344/anpr-71-2_continuing_edu By Heidi Moawad, MDDr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications. Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error OtherThe Hidden Symptoms Of Hemophilia We Rarely Talk About
When people hear the word "hemophilia," they often picture severe bleeding, bruising, or swollen joints. Those are the visible symptoms, the ones doctors, nurses, and even family members understand. But living with a bleeding disorder is so much more than what meets the eye.
There are symptoms we don't talk about enough, the ones that don't show up in blood work or on an MRI. They don't leave physical scars, but they shape our daily lives as much as a joint bleed or a hospital visit.
Managing a bleeding disorder takes energy, more than most people realize. Our bodies work harder to heal even the smallest injuries, and that takes a toll. Women especially battle anemia and iron deficiency. Some days fatigue washes over me like a heavy blanket, making even simple tasks feel overwhelming.
It's not the kind of tiredness that a good night's sleep fixes. It's deep, persistent, and often misunderstood. "You look fine," people say, unaware that my body is fighting in ways they can't see.
Even when a bleed is resolved, the pain can linger. Joint damage from repeated bleeds doesn't just disappear when the swelling goes down. Many of us live with arthritis or chronic joint pain, often years before people without a bleeding disorder would expect to develop it.
This kind of pain isn't always dramatic; it can be a dull ache in the morning, a sharp twinge when I move the wrong way, or a stiffness that reminds me my joints have a history they won't let me forget.
Brain fog and other mental issuesHave you ever woken up in a hotel room and forgotten where you are? Imagine that feeling, but all the time. Brain fog is real, and it's frustrating. Whether it's from chronic pain, fatigue, or the emotional toll of managing a lifelong condition, my mind sometimes feels like it's running on a delay.
I struggle to find words, forget small details, or feel like my thoughts are stuck in molasses. It's not a sign of laziness or distraction; it's another hidden symptom of living with hemophilia or another a chronic condition.
Even on good days, there's a background noise of worry. What if I get hurt and can't access my treatment in time? What if this pain means another joint bleed? What if insurance denies my medication?
Anxiety isn't listed on any hemophilia fact sheet, but it should be. We learn to be hyperaware of our bodies, always scanning for signs of a problem. That constant state of alertness can be exhausting.
These hidden symptoms don't come with dramatic visits to the emergency room or visible bruises, but they are just as real. We need to talk about them, not just among ourselves but with doctors, caregivers, and even employers. Understanding the unseen parts of hemophilia helps us create a world that truly supports those of us living with it.
If any of this sounds familiar, you're not alone. It's time we start talking about all of hemophilia, not just the parts people expect to see.
Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to hemophilia.
Side Effects Of Clopidogrel Oral Tablet
As with other drugs, clopidogrel can cause side effects, such as bruising and bleeding. If you are not able to tolerate side effects from clopidogrel, talk with your doctor or pharmacist.
Clopidogrel comes as an oral tablet. Clopidogrel is also available as the brand-name drug Plavix.
Read on to learn about potential common, mild, and serious side effects of clopidogrel. For more information about clopidogrel, including details about its uses, see this clopidogrel overview.
Clopidogrel can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects persist, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took clopidogrel in clinical trials:
Mild side effects can occur with clopidogrel use. This list does not include all possible mild side effects of the drug. For more information, you can refer to the drug's prescribing information.
Mild side effects that have been reported with clopidogrel include:
These side effects may be temporary, lasting a few days to weeks. However, if the side effects continue, bother you, or become severe, be sure to talk with your doctor or pharmacist.
For more information about some of these side effects, see the "Clopidogrel: Side effect specifics" section.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking clopidogrel and want to tell the FDA about it, visit MedWatch.
Clopidogrel may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to the prescribing information for clopidogrel.
If you develop serious side effects while taking clopidogrel, call your doctor right away. If the side effects seem life threatening or you think you're having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported with clopidogrel include:
For more information about these side effects, see the "Clopidogrel: Side effect specifics" section.
Allergic reaction
For some people, clopidogrel can cause an allergic reaction. This side effect wasn't reported in the drug's studies, but it has been reported since the drug was approved.
In general, symptoms of allergic reaction can be mild or serious.
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They'll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you've had a serious allergic reaction to clopidogrel oral tablet, your doctor may recommend taking a different medication instead.
Clopidogrel has a boxed warning. A boxed warning is the most serious warning from the FDA.
Reduced effect in people with certain drug metabolism problems
For clopidogrel to work for you, your body first has to metabolize (break down) the drug into its active form. An enzyme in your body called cytochrome p450 2C19 (CYP2C19) is responsible for this. If CYP2C19 doesn't work well, clopidogrel may not be effective for you. This means it may not work to help prevent heart attack and stroke.
CYP2C19 may not work well if you have certain genetic factors that cause you to have a less active version of this enzyme. (This is called being a CYP2C19 poor metabolizer.) Your doctor may order certain genetic tests before prescribing clopidogrel to make sure the drug is right for you.
CYP2C19 may also not work well if you take certain medications, especially omeprazole (Prilosec) or esomeprazole (Nexium). These medications slow down the action of CYP2C19. Your doctor likely will not prescribe clopidogrel with these medications.
What you can do
If either of these factors apply to you, talk with your doctor before taking clopidogrel. Your doctor may prescribe a medication other than clopidogrel to help prevent heart attack and stroke.
While taking clopidogrel, you should not take over-the-counter medications that contain omeprazole (Prilosec OTC) or esomeprazole (Nexium 24HR).
If you have questions about this warning, talk with your doctor or pharmacist.
Learn more about some of the side effects that clopidogrel may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for clopidogrel.
Bleeding
Clopidogrel is a blood thinner that helps prevent heart attack and stroke by making it harder for your blood to form clots. Because of this, the medication can raise your risk of bleeding. Bleeding was the most common side effect reported in studies of clopidogrel. Minor bleeding was common, while major bleeding occurred rarely. Major bleeding can be life threatening.
Examples of minor bleeding can include:
Examples of major bleeding include internal bleeding, such as in your digestive system, urinary tract, lungs, or brain. Symptoms of major bleeding vary depending on the location of bleeding but can include:
Risk factors
Factors that can increase the risk of bleeding when taking this drug include having surgeries and taking certain other drugs. Examples of medications that may increase this risk include:
What you can do
To help prevent bleeding while taking clopidogrel, take extra care when using sharp tools or doing activities that could lead to injury. If cycling, be sure to wear a helmet. Always check with your doctor or pharmacist before taking other drugs with clopidogrel.
If you have an upcoming surgery or dental procedure, be sure to talk with your doctor at least 5 days beforehand. In some cases, your doctor may recommend temporarily stopping clopidogrel before surgery to reduce your risk of bleeding.
While taking clopidogrel, see your doctor right away if you have symptoms of major bleeding. Also, see your doctor right away if you have a head injury. They'll likely run tests to check for major bleeding. If you have a major bleed, your doctor may temporarily stop your clopidogrel treatment.
Note that you should not stop taking clopidogrel unless your doctor recommends this. Stopping clopidogrel can raise your risk of heart attack and stroke.
If you have questions about the risk of bleeding with clopidogrel, talk with your doctor or pharmacist.
Thrombotic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura (TTP) can occur with clopidogrel. This side effect wasn't reported in studies of clopidogrel but has been reported since the drug became available. TTP is a rare but serious disorder in which blood clots form in small blood vessels in your body.
TTP may cause symptoms such as:
What you can do
If you have symptoms of TTP that occur without an obvious cause, see your doctor right away. They'll likely order blood tests to check for TTP. If you have this condition, you'll likely need treatment in a hospital. Your doctor will likely stop your clopidogrel treatment.
If you have questions about the risk of TTP with clopidogrel, talk with your doctor or pharmacist.
Here are answers to some frequently asked questions about clopidogrel's possible side effects.
Can clopidogrel cause side effects in older adults?
Clopidogrel can cause similar side effects in older (age over 65 years) and other adults who take the medication. The most common side effect is an increased risk of bleeding. To read more about this side effect, see the "Clopidogrel: Side effect specifics" section.
Doctors typically prescribe the same dosage of clopidogrel for older adults and other adults.
If you have questions about the safety of clopidogrel given your age, talk with your doctor or pharmacist.
Does taking atorvastatin with clopidogrel cause side effects?
No, that's not likely. Atorvastatin (Lipitor) and clopidogrel are not known to interact. And they don't cause similar side effects. It's generally considered safe to take these medications together.
Atorvastatin is prescribed to lower high cholesterol levels, while clopidogrel is prescribed to help prevent blood clots. Doctors commonly prescribe atorvastatin with clopidogrel to help prevent heart attack and stroke. (Some types of blood clots can cause heart attack or stroke.)
If you have questions about taking atorvastatin with clopidogrel, talk with your doctor or pharmacist.
Does clopidogrel cause long-term side effects?
It's unlikely. Long-term side effects weren't reported in studies of clopidogrel. Long-term use of clopidogrel isn't known to raise the risk of side effects from the drug.
Long-term side effects include those that may start at any time you're taking a drug, even if you've taken it for a long time. It also includes side effects that may not go away, even after you stop taking the drug.
If you're concerned about possible long-term side effects from clopidogrel, talk with your doctor or pharmacist.
Consider the following important information before taking clopidogrel.
Clopidogrel has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the "Clopidogrel: Boxed warning" section.
Other precautions
Before taking clopidogrel, discuss your health history with your doctor. Clopidogrel may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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