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Archive for the ‘Diagnosis’ Category

Clotting Disorders (Thrombophilia): Who Should Be Tested? What To Test?

| Antiphospholipid antibodies, Antithrombin deficiency, APC resistance, Clotting disorder - thrombophilia, Factor V Leiden, Homocysteine, MTHFR, Inherited (genetic), Protein C deficiency, Protein S deficiency, Prothrombin 20210 mutation, Thrombophilia lab tests, Whom to test | Comments Off on Clotting Disorders (Thrombophilia): Who Should Be Tested? What To Test?

Stephan Moll, MD writes… A publication today in the journal Vascular Medicine discusses – for patients and family members – (a) in which patient with blood clots (DVT, PE) to consider testing for a clotting disorder, (b) what tests might be appropriate to do, (c) how the test results influence management with blood thinners, (d) what birth control methods are safe in women with history of blood clots or a clotting disorder,  and (e) in which family members to consider thrombophilia testing (link here for the article).

 

Disclosures:  None

Last updated: April 1st, 2015

 

 

Diagnosis of recurrent DVT and PE: A patient’s guide to the clinical care guidance used by healthcare professionals

| Diagnosis, Guidelines, Uncategorized, Venous clots | Comments Off on Diagnosis of recurrent DVT and PE: A patient’s guide to the clinical care guidance used by healthcare professionals

Beth Waldron, Clot Connect program director, writes…

If you’ve experienced deep vein thrombosis (DVT) or pulmonary embolism (PE), a recurrence of a blood clot in the future is a concern.   Diagnosing a recurrent clot can be a challenge because it is sometimes difficult to tell if symptoms are the result of a new clot or the signs of chronic damage from the initial clot.

  • Around 40% of patients with DVT develop long-term pain and swelling, known as post-thrombotic syndrome.  Such pain and swelling can fluctuate, and be particularly pronounced after standing for prolonged periods of time or being overly active.
How do healthcare professionals know when symptoms are the result of a past blood clot or due to a new clot?  Read the rest of this entry »

Thrombophilia and Insurance

| Clotting disorder - thrombophilia, Inherited (genetic), Psychological and social consequences of blood clots, Thrombophilia lab tests | 4 Comments »

Liz Varga, Certified Genetic Counselor, Nationwide Children’s Hospital, Columbus OH writes….

Some people may have concerns about genetic testing for clotting disorders (thrombophilias) for fear of genetic discrimination.  Fortunately in the United States, we have laws in place that can alleviate this concern. Read the rest of this entry »

Chronic Lung Damage after PE – Pulmonary Hypertension (CTEPH)

| Diagnosis, Medical tests, Pulmonary embolism | 4 Comments »

Blood clots in the lung (pulmonary embolism, PE) often completely dissolve within a few weeks or months and a patient’s symptoms of shortness and breath and chest pain disappear.  Many people return to their normal self and have no physical limitations thereafter. Other people have some residual symptoms of shortness of breath or chest discomfort, but adjust to it well.  However, in a few patients, clots do not completely dissolve and significant chronic damage to the lung results. Read the rest of this entry »

PFO = Patent Foramen Ovale

| Anatomy, Arterial clots, Deep vein thrombosis (DVT), Diagnosis, Medical tests | 1 Comment »

Anatomy

Some people have a “hole in the heart”, called a “patent foramen ovale” (PFO). This is a connection between the right and the left chamber (atrium) of the heart. We are all born with it – the unborn needs this connection for proper blood circulation. In most people the hole closes in the first few weeks after birth. However, in up to 25 % of people it stays open, equally often in men and women. A PFO usually does not cause symptoms. However, when a person has an acute DVT (deep vein thrombosis) and a clot breaks off and travels with the blood stream, it may cause problems.

DVT and PE in the person without PFO

In the person who does not have a PFO, a clot that breaks off from a DVT travels with the blood stream through the main vein in the abdomen to the chambers of the right side of the heart (color blue in figure 1 and 2). From there, it travels into the lung vessels, where it gets lodged, causing a pulmonary embolism (figure 1).

Figure 1. DVT and PE, no PFO present (graphic design: Jeff Harrison, Wilmington, NC; ©Stephan Moll)

Read the rest of this entry »

Family Member Testing for Thrombophilia

| Clotting disorder - thrombophilia, Factor V Leiden, Inherited (genetic), Protein C deficiency, Protein S deficiency, Prothrombin 20210 mutation, Thrombophilia lab tests | 4 Comments »

Stephan Moll, MD writes…

Background

If a thrombophilia (clotting disorder) has been identified in a patient with blood clots (venous thromboembolism = VTE), the question arises whether other family members should be tested for the same thrombophilia.

My Clinical Approach

My approach in clinical practice to thrombophilia testing in family members is summarized in table 1:  Testing of Family Members. Read the rest of this entry »