Q:
Hello, my mom was getting alot of bloody noses. Then she was rushed to the hospital because her nose was really bleeding heavy. They had to caterize the inside she had 4 or 5 veins that needed to be caterized. My mother has always has low blood pressure. The doctor ordered a Fribrinogen test that was high . My questions is could the high fibrinogen level be caused from the trauma to her nose from the caterization and if not should she have additional test ordered ?? Thanks
A:
A high fibrinogen level is not going tell very much.
One out of every seven people will develop a nosebleed at some time in their lives. Nosebleeds tend to occur more often during winter months and in dry, cold climates. They can occur at any age, but are most common in children aged 2 to 10 years and adults aged 50 to 80 years. For unknown reasons, nosebleeds most commonly occur in the morning hours.
Most nosebleeds do not have an easily identifiable cause:
- exposure to warm, dry air for prolonged periods of time,
- nasal and sinus infections,
- allergic rhinitis,
- nasal foreign body (object stuck in the nose),
- vigorous nose blowing,
- nasal surgery,
- deviated or perforated nasal septum, and
- cocaine use.
Less commonly, an underlying disease process or taking certain medications may cause a nosebleed or make it more difficult to control.
- Inability of the blood to clot is most often due to blood-thinning medications such as warfarin (Coumadin), clopidogrel bisulfate (Plavix), nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin.
- Topical nasal medications, such as corticosteroids and antihistamines, may sometimes lead to nosebleeds.
- Liver disease, chronic alcohol abuse, kidney disease, platelet disorders, and inherited blood clotting disorders can also interfere with blood clotting and predispose to nosebleeds.
- Vascular malformations in the nose and nasal tumors are rare causes of nosebleeds.
- High blood pressure may contribute to bleeding, but is rarely the sole reason for a nosebleed. It is often the anxiety associated with the nosebleed that leads to the elevation in blood pressure.
Laboratory tests are usually not needed. For severe nosebleeds, however, a blood count may be checked to assess the degree of blood loss. For individuals with blood clotting disorders or for those taking blood thinners, additional blood tests may also be ordered. If there are concerns about malignancy or other less common causes of nosebleeds, further blood tests and/or imaging studies may be considered.
Hope this helps,
Dr T