Core IM | Internal Medicine Podcast #99 Bleeding vs. Clotting Risk: Gray Matters Segment
Feb 23, 2022
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Case Presentation
- A 64-year-old male with minimal past medical history presented with leg swelling, fatigue, and anxiety.
- Imaging revealed DVT, PE, and a 15cm liver mass, prompting the question of anticoagulation management for biopsy.
Anticoagulation Duration and Recurrence Risk
- One month of anticoagulation is a minimum for PE due to high recurrence risk, particularly within the first 30 days.
- Risk decreases after three months, but doesn't disappear, with early recurrence being common after anticoagulation cessation.
Clot Propagation Despite Anticoagulation
- Despite anticoagulation, the patient experienced clot propagation, raising concerns about management.
- This led to questions about bridging DOACs with heparin and the appropriate duration of anticoagulation interruption.