Treatment of thrombophilic states

Treatment often the same in patients with and without laboratory evidence of thrombophilia.

Acute thrombotic event

• Treat appropriately—usually with heparin/warfarin.

• In PC/PS patients make sure heparinisation is adequate—monitor warfarin induction closely to avoid skin necrosis. Patients with AT deficiency do not usually require high heparin doses.

• Duration of anticoagulation following a first event will depend on the severity of the VTE and clinical risk factors for recurrence; each patient needs to be individually assessed. Heritable thrombophilia is not an indication of itself for life-long anticoagulation.

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