Ten Venous Disease Coalition Hypercoagulability VTE T oolkit Thrombophilia Hypercoagulability Deficiencies of Antithrombin Protein C Protein S ID: 433884
Download Presentation The PPT/PDF document "Chapter" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Chapter
Ten
Venous Disease Coalition
Hypercoagulability
VTE
ToolkitSlide2
Thrombophilia
=
Hypercoagulability
Deficiencies of: Antithrombin
Protein C Protein S Heparin cofactor II
Factor VIII, IX, XI, II Hyperhomocysteinemia
Fibrinolytic dysfunction
Myeloprolif. disorders:
- PRV, ET
Dysfibrinogenemia
DIC
Factor V Leiden
Prothrombin
20210A variant
Antiphospholipid
Ab syndrome - lupus anticoagulant - anticardiolipin antibody
VTE Toolkit
DIC = disseminated
intravscular
coagulation;
ET = essential
thrombocytosis
; PRV =
polycythemia
rubra
veraSlide3
Which patients have an increased risk of having a
hypercoagulable
state?
VTE Toolkit
Unprovoked
VTE at a young age Recurrent, unprovoked VTE events VTE with positive family history VTE at an
unusual site
Slide4
Which patients have an increased risk of having a
hypercoagulable
state?
VTE Toolkit
Unprovoked
VTE at a young age Recurrent, unprovoked VTE events VTE with positive family history VTE at an
unusual site
AND
ALSO
Any unprovoked VTE event
VTE
with minor risk factor
such as BCP,
HRT
, pregnancy, travel,
bedrest
only
Unexplained
, recurrent
pregnancy lossesSlide5
General Indications for
Hypercoagulability
Testing
VTE Toolkit
ONLY if patient management will be
affected by the result: Management
affected?
Duration of
anticoagulation
(rarely)
Another medical intervention
pregnancy prophylaxis
(sometimes)
BCP
, HRT
avoidance
(possibly)Family counseling (virtually never)Slide6
Principles of
Hypercoagulability
Testing
VTE Toolkit
Should only by
done by experts - both in hypercoagulability + in the provision of evidence-based patient counseling2. Only if management is (should be) affected by the result = rare
Almost never test
relatives
- net harm generally greater than net benefitSlide7
Venous Disease Coalition
www.vasculardisease.org/venousdiseasecoalition/
VTE
T
oolkit