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Thrombophilia and Hypercoagulable States

Jasmine S Beria, DO, MPH and Dina Chenouda, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • An inherited or acquired disorder of the coagulation system predisposing an individual to thromboembolism (the formation of a venous, or less commonly, an arterial blood clot)

  • Venous ...

DIAGNOSIS

HISTORY

Consider prothrombotic assessment for the following: 
  • Thrombosis at an unusual anatomic site (e.g., cerebral, mesenteric, portal, hepatic) or recurrent thromboses

  • Family history suggest...

TREATMENT

  • Assess VTE risk:

    • Low-risk inherited thrombophilias: heterozygous FVL, heterozygous prothrombin 20210 mutation

    • High-risk inherited thrombophilias: protein C deficiency, protein S defi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Monitor warfarin with INR goal of 2 to 3. 

DIET

  • Vitamin K–stable diet if patient is taking warfarin

  • Rivaroxaban should be taken with a large meal ...

REFERENCES

1
Heit  J. Epidemiology of venous thromboembolism. Nat Rev Cardiol.  2015;12(8):464–474. [View Abstract on OvidMedline]
2
...

CODES

ICD10

  • D68.59 Other primary thrombophilia

  • D68.51 Activated protein C resistance

  • D68.2 Hereditary deficiency of other clotting factors

  • D68.8 Other specified coagulation defects

  • D53.0 Protein deficiency...

CLINICAL PEARLS

  • FVL (resistance to aPC) is the most common inherited thrombophilia.

  • Test patients for thrombophilias only if it will affect management of the condition.

  • For patients with VTE <45, sug...

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