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The ESC Textbook of Intensive and Acute Cardiac Care$
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The ESC Textbook of Intensive and Acute Cardiac Care

Edited by Marco Tubaro, Nicolas Danchin, Gerasimos Filippatos, Patrick Goldstein, Pascal Vranckx, Doron Zahger

European Society of Cardiology Acute Cardiac Care ESC Working Group Acute Cardiovassular Care Associations

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Publisher:
Oxford University Press
Print Publication Date:
Jan 2011
Print ISBN-13:
9780199584314
Published to Oxford Medicine:
Jan 2011
DOI:
10.1093/med/9780199584314.001.0001
© European Society of Cardiology

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Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Coagulation and thrombosis

Chapter:
Coagulation and thrombosis
Author(s):

Anne-Mette Hvas,

Erik Lerkevang Grove,

Steen Dalby Kristensen

DOI:
10.1093/med/9780199584314.003.0038

Coagulation is evaluated by conventional analyses, often supplemented by point-of-care tests. Currently, a number of point-of-care tests for evaluation of platelet function and the efficacy of antiplatelet therapy are being investigated. Thrombophilia contributes to the risk of thrombosis, and a battery of complex assays is required to identify all thrombophilias.

Disseminated intravascular coagulation (DIC) is characterized by microthrombosis and clinical bleeding. A scoring system for overt DIC provides a five-step diagnostic algorithm. The cornerstone of DIC management is treatment of the underlying triggering condition.

Heparin-induced thrombocytopenia (HIT) is an adverse immunological effect of heparin therapy. Besides thrombocytopenia, the major clinical consequence of HIT is an enhanced risk of thrombosis. The diagnosis is based on the clinical picture and detection of platelet-activating HIT antibodies. When HIT is strongly suspected, it is recommended to stop heparin treatment, order laboratory tests for HIT antibodies, and initiate nonheparin anticoagulant treatment.

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