Part 4: Venous Thromboembolism

Elisabeth M. Battinelli, MD, PhD

Assistant Professor of Medicine, Harvard Medical School, Associate Physician, Division of Hematology, Brigham and Women's Hospital, Boston, MA

Jean M. Connors, MD

Assistant Professor of Medicine, Harvard Medical School, Medical Director, Anticoagulation Management Service, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA

Question 3

A 44-year-old man arrives in clinic to discuss his risk of developing a thrombotic event. His mother, age 76, was recently diagnosed with antiphospholipid syndrome after suffering a PE and testing positive for lupus anticoagulant on 2 separate occasions 3 months apart. His mother is currently on anticoagulation and the patient is worried that he also has a risk of developing a thrombotic event because of his family history. During the visit, it is noted that the patient is obese (body mass index [BMI] ≥30) and leads a sedentary lifestyle.

What should the physician tell the patient regarding his risk of having a thrombotic event in the future?

  •   The patient should undergo testing for lupus anticoagulant and
    anticardiolipins to determine whether or not he inherited his motherís
    antiphospholipid syndrome
  •   Explain to the patient that the antiphospholipid syndrome is not
    inherited and he has no risk factors for thrombosis
  •   Explain to the patient that although antiphospholipid syndrome is
    not inherited, he is at risk of VTE because of his obesity
  •   The patient has a family history of VTE and therefore a complete
    hypercoagulable workup should be undertaken at todayís visit

Updated 11/21/2013 • jdw | Copyright ©2014 Turner White Communications