I normally tell my patients that they are likely to make a full recovery from a deep vein thrombosis or a pulmonary embolus. Unfortunately some people do develop long-term complications such as post phlebitic syndrome causing chronic leg problems, but in general I do not expect long-term problems. However there is some evidence that having a DVT or PE can have an impact on day … [Read more...]
Weekend reflection: Ethics of medical trials
Berlin This week I am in Berlin about to attend the International Society of Thrombosis and Haemostasis meeting (ISTH 2017). It is a meeting where doctors and scientists present their latest research. The importance of ethics in research has been brought into sharp focus for me this week as Angela and I visited some of the historic sites in Berlin. Sachsenhausen Berlin is a … [Read more...]
Clotting: the Swiss connection
Swiss precision This week I am on my way to the International Society of Thrombosis and Haemostatsis meeting in Berlin. This is a great opportunity to catch up with all the latest developments and research in the field of blood clotting. As a stopover, Angela and I spent a couple of days in Zurich in Switzerland; what a beautiful city. I thought there must be some link … [Read more...]
Clot detectives
I attended the Haematology Society of Australia and New Zealand regional meeting in Auckland last week. Professor Barbara Bain, a highly regarded International expert from London was one of the invited speakers. She gave a really interesting talk on "Haematologists as Detectives". She highlighted some of the cases of poisoning and accidental drug errors that were picked up by … [Read more...]
Clots in Pregnancy – Treatment
A confirmed deep vein thrombosis (DVT) or pulmonary embolus (PE) should be treated with low molecular weight (LMW) heparin (enoxaparin, dalteparin or tinzaparin) immediately. Even if the diagnosis is only suspected you should start on treatment and only stop when the ultrasound scan or CTPA excludes a clot. LMW heparin is given as a subcutaneous injection. In the past … [Read more...]
Clots in Pregnancy – Diagnosis
Deep vein thrombosis The diagnosis of a DVT in pregnancy is made using similar methods to those used in women who are not pregnant, but the d-dimer test is not so reliable. The d-dimer measures the breakdown products of blood clot. It is used to exclude a blood clot so people with a low level have a low risk of a blood clot. However the baseline level of the d-dimer in the … [Read more...]
Clots in Pregnancy – Symptoms
In my previous post about DVT in pregnancy I looked at the incidence of clots in Pregnancy. DVT is relatively rare but serious and should not be missed. The Royal College of Obstetricians and Gynaecologists guidelines quote that approximately 20% of DVTs can lead to a pulmonary emboli in pregnancy and these can be rapidly fatal. A suspected case of DVT should be … [Read more...]
Frivolous Friday – modern art and coagulation
I'd never visited Australia's capital city, Canberra, so when an opportunity arrived for a girl's weekend there, I was very excited. I arrived there with two of my daughters and my daughter-in-law for the hottest weekend on record. The temperature was 39 degrees, so we were very pleased to enter the air-conditioned National Gallery. It was a great way to spend a morning (as … [Read more...]
Children don’t need anticoagulants after surgery – why?
This week my son Isaac had surgery on his knee for a dislocated patella. Fortunately it all went well, but he will be in plaster for the next 5 weeks. Shouldn't he have anticoagulant prophylaxis to prevent a blood clot? In Adults knee surgery is associated with a high risk of thrombosis and many international guidelines suggest giving prophylaxis for several weeks after knee … [Read more...]
Clots in pregnancy – How common?
Pregnancy Deep vein thrombosis and pulmonary embolus are serious complications of pregnancy. They are potentially life-threatening and can lead to long-term complications. Pulmonary embolus is the commonest cause of maternal death in most developed countries, so being aware of the risks and signs is very important. Increased risk of clotting Pregnancy is sometimes referred … [Read more...]