 This reduces NO-dependent vasodilation and induces platelet activation, thrombin generation, procoagulant factors and tissue factor activation, contributing to the formation of thrombosis.This can lead to esophageal spasm and dysphagia, abdominal pain, erectile dysfunction, systemic hypertension, decreased organ perfusion, promotion of inflammation and coagulation, and thrombosis.Chronic hemolysis may also lead to endothelial dysfunction, heightened endothelin-1-mediated responses and vasculopathy.