What diagnostic studies are warranted, and how should a patient with suspected heparin-induced thrombocytopenia and pulmonary embolism be treated?
This clinical vignette reviews the diagnostic and therapeutic approach to suspected heparin-induced thrombocytopenia complicated by pulmonary embolism following cardiac surgery.
A 63-year-old man with coronary artery disease who has recently undergone bypass surgery presents with dyspnea. Laboratory testing reveals a platelet count of 86,000 per cubic millimeter, as compared with 225,000 per cubic millimeter at the time of discharge nine days earlier. Findings on chest radiography are unremarkable; spiral computed tomography of the chest shows a pulmonary embolism. Heparin-induced thrombocytopenia is suspected. What diagnostic studies are warranted, and how should this patient be treated?
Arepally et al. (Wed,) studied this question.
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