Bloody Minded Episode 4 - Forever Alone: The Isolated Prolonged aPTT
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Jun 4, 2024 Feeling isolated? The discussion dives into the challenges and mysteries of isolated prolonged aPTT, a common yet puzzling problem. Learn about the crucial role of heparin and how it can skew results. They unravel the complexities of hematology testing, emphasizing the importance of thorough patient history. The episode also highlights navigating coagulation disorders and the significance of accurate interpretation through mixing studies. Get ready for an informative journey through the nuances of coagulation and patient diagnostics!
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Heparin Contamination in Hospitals
- In a hospital setting, heparin contamination is a very common cause of isolated, elevated APTTs.
- Always consider heparin exposure when evaluating a patient with this finding.
Testing for Heparin Contamination
- Test for heparin contamination using a heparin-resistant APTT or polybrine neutralization if available.
- If the heparin-resistant test is normal, the elevated APTT is likely due to heparin.
DOACs and Coagulation Tests
- DOACs (direct oral anticoagulants) affect both PT and APTT variably, making coagulation tests unreliable.
- A thorough history is crucial for patients on DOACs, as test results can be misleading.