Heparin induced thrombocytopenia HIT : unknown Etiology ,and rare
to occur , it's simply thrombosis and thrombotic events after the onset of heparin treatment
, it’s not a bleeding event it’s thrombosis with thrombocytopenia
If thrombosis develops in a patient who started heparin ttt
secondary to a pulmonary embolism,,
Consider HIT or thrombosis occur secondary to a hypecoagulable
state associated with Cancer that's very resistant to Heparin therapy , think of
alternatives like argatroban and lepirudin, also IVC filters , though filters
may predispose for thrombosis and embolism
: ((
Warfarin Skin Necrosis: simple to understand warfarin,
decreases production of Vit k dependent clotting factors, so its effect to appear and till INR reaches therapeutic
levels and PT Increases (i.e. Factor VII depleted ) body stores of clotting
factors should be consumed first, interesting to know that Anticoagulant factor
Protein C has a shorter half life than procoagulant factors , So you expect coagulation event manifested commonly as skin necrosis to occur before
anticoagulant action of warfarin takes place and that’s why warfarin ttt should
be initiated under the umbrella of Heparin
,,
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