The elderly, those with cancer, smokers, and those with a family history of clotting disorders are more susceptible to blood-related emergencies. (Source: Freepik)
WHEN we think of medical emergencies, heart attacks or strokes often come to mind. But there’s another category of silent yet equally dangerous crises – those involving the blood. According to Sunway Medical Centre, Sunway City consultant haematologist and transplant haematologist Dr Andy Tang Sing Ong, blood-related emergencies such as clots, severe bleeding and acute anaemia can escalate within minutes, making early recognition crucial to survival.
Dr Tang specialises in blood disorders, laboratory haematology and stem cell transplantation. He is trained in haematology and transplant medicine with international certifications. “Not all haematology emergencies are silent killers,” Dr Tang explains. “Some do present early warning signs – but they’re often ignored or misunderstood.”
When the blood turns dangerous
Blood clots are among the most life-threatening haematology emergencies. When a clot forms in a deep vein, usually in the leg – a condition known as deep vein thrombosis (DVT) – it can travel to the lungs and block blood flow, causing a pulmonary embolism (PE). Both can be fatal if untreated.
“The common symptoms include pain, swelling and redness in one leg, especially after a long flight or prolonged rest,” says Dr Tang. “If you suddenly experience chest pain, breathlessness or a racing heartbeat, it may mean the clot has travelled to the lungs. You must get medical help immediately.”
People at higher risk include the elderly, those with cancer, individuals on hormone therapy or birth control pills, smokers, and those with a family history of clotting disorders. But even young, healthy individuals can develop clots after long hours of immobility or during severe infections.
At the opposite end of the spectrum are bleeding crises, which can occur in people with conditions like haemophilia, or those taking blood thinners, or following trauma or surgery. Dr Tang warns that uncontrolled bleeding can rapidly deplete the body’s blood supply.
“Our body holds about four to five litres of blood,” he says. “If you lose more than 10% quickly, your organs can fail due to lack of oxygen. Every second counts.”
He stresses that even minor signs – unexplained bruises, frequent nosebleeds, gum bleeding, or unusually heavy periods – should never be dismissed.
“Many women think excessive menstrual bleeding is normal because their mothers or aunts had the same. But sometimes, it’s an inherited bleeding disorder. Unfortunately, many only find out during childbirth or surgery, when it’s too late.”
Dr Tang: Be vigilant. Every second counts in a haematology emergency. If you come late, even the best medicine may not save your organs or your life.
Seconds that save lives
In haematology emergencies, swift stabilisation is critical. “For bleeding, we first secure the airway, breathing and circulation, then replace lost blood either through transfusion or, in milder cases, intravenous iron therapy,” Dr Tang explains.
“For clots, management of such cases typically involves stabilisation and supportive measures. Specialised treatment is typically provided at tertiary medical centres.”
Blood cancers such as leukaemia and lymphoma also demand rapid action. In acute leukaemia, for instance, abnormal white blood cells multiply so fast that they can block small vessels, causing internal bleeding or organ failure. “If untreated, a patient’s condition can deteriorate within hours,” Dr Tang says.
Behind every emergency response is the silent hero – the blood donor. “Donated blood saves lives every day,” says Dr Tang. “It’s vital for patients with cancer, thalassaemia or severe bleeding, and for those undergoing surgery or chemotherapy.”
Blood donation, he notes, is safe and straightforward. “It’s just like having a blood test, except you give a bit more. The blood is then processed into components – red cells, platelets and plasma – and tested thoroughly for infections before being used.”
He urges healthy Malaysians to donate regularly, as national blood reserves often dip during festive seasons or public holidays. “Blood donations play a critical role in supporting patient care nationwide. You’re not just giving blood – you’re giving time and hope.”
Who’s most at risk?
Dr Tang points out that certain people are genetically predisposed to clotting or bleeding disorders. Others develop these conditions due to external factors such as obesity, smoking, hormone therapy or prolonged immobility. “If you have a personal or family history of clotting or bleeding, talk to your doctor,” he advises. “There are blood tests to determine your risk.”
For everyone else, awareness and vigilance are the best defences. “If you notice sudden leg swelling, chest pain, breathlessness or unusual bleeding – don’t wait. Go to the emergency department. Early detection can prevent death or permanent organ damage.”
Dr Tang also hopes to dismantle misconceptions that stop people from seeking care. “Some fear the diagnosis will affect their insurance or social reputation, so they delay getting help. But your health must come first. It’s always better to know early than too late.”
Having trained and practised in both local and international settings, he emphasises the importance of early recognition in medical emergencies. The Sarawak-born haematologist has seen firsthand how awareness saves lives.
Dr Tang’s message is simple: “Be vigilant. Every second counts in a haematology emergency. If you come late, even the best medicine may not save your organs or your life.”
