Dx/Rx: Coronary Thrombosis

Tightly organized into a super-condensed outline bulleted format, this handy, pocket-sized manual details precise, up-to-date information for diagnosis and treatment of Coronary Thrombosis. Throughout the book, tables and figures summarize important clinical data and current professional society recommendations, while salient references direct readers to additional information. Current, quick, and concise, for instant access on the ward or in the clinic! ALSO AVAILABLE FOR YOUR PDA! Based on Dx/Rx: Coronary Thrombosis, the PDA version provides quick access to information from the book, including tables and figures. For more information, please contact your Publisher's Representative at 800-832-0034.

Editor's Preface

xi

Preface

xiii

Acknowledgments

xv

1 Introduction

1

(8)

Platelets

1

(2)

Historical Perspectives

1

(1)

Production

1

(1)

Structure

1

(1)

Structure-Function Relationship

1

(1)

Biology and Physiologic Response

2

(1)

Other Platelet Functions

2

(1)

Coagulation Factors

3

(2)

Historical Perspectives

3

(1)

Physiologic Constructs

4

(1)

References

5

(4)

2 Arterial Thrombosis

9

(4)

References

11

(2)

3 Venous Thrombosis

13

(2)

References

4

(11)

4 Thrombophilia

15

(26)

Historical Landmarks

15

(2)

Inherited Thrombophilias

17

(6)

AT Deficiencies

17

(1)

PC Deficiency

18

(1)

PS Deficiency

19

(1)

APC Resistance

19

(2)

Factor II (Prothrombin) G20210A

21

(1)

Dysfibrinogenemias

21

(1)

Hyperhomocysteinemia

22

(1)

Acquired Thrombophilias

23

(4)

Antiphospholipid Antibody Syndrome

23

(1)

ACL Antibody Thrombosis Syndrome

24

(1)

LA Thrombosis Syndrome

25

(1)

Malignancy

26

(1)

Initial Assessment

27

(1)

Screening for Thrombophilias

28

(4)

Selection of Patients

28

(1)

Selection of Laboratory Tests

28

(4)

Management of Venous Thrombosis

32

(1)

Duration of Therapy

33

(3)

Specific Thrombophilic Disorders

36

(1)

APL Syndrome

36

(1)

Approach to Asymptomatic Carriers

36

(1)

References

37

(4)

5 Deep Venous Thrombosis and Pulmonary Embolism

41

(14)

Background

41

(1)

Diagnosis

41

(6)

Diagnosis of DVT

41

(2)

Diagnosis of PE

43

(4)

Management

47

(5)

Management of DVT

47

(2)

Management of PE

49

(3)

References

52

(3)

6 Acute Coronary Syndromes

55

(20)

Background

55

(1)

Diagnosis

55

(1)

Acute Treatment

56

(2)

ST Segment Elevation MI

58

(6)

Fibrinolytic Therapy-Based Reperfusion

58

(1)

Oral Platelet-Directed Therapy

58

(1)

Intravenous Platelet-Directed Therapy

58

(3)

Thrombin-Directed Therapy

61

(2)

Percutaneous Coronary Intervention-Based Reperfusion

63

(1)

Unstable Angina and Non-ST Segment Elevation MI

64

(2)

Platelet-Directed Therapy

64

(1)

Intravenous Platelet-Targeted Therapy

65

(1)

Thrombin-Targeted Therapy

66

(1)

Long-Term Treatment

66

(3)

Recommendations

69

(1)

References

69

(6)

7 Percutaneous Coronary Intervention and Coronary Arterial Bypass Grafting

75

(6)

Background

75

(1)

Diagnosis

75

(1)

Management

76

(2)

Platelet-Directed Therapy

76

(1)

Thrombin-Directed Therapy

77

(1)

Coronary Bypass Grafts

78

(1)

References

79

(2)

8 Cardiomyopathy

81

(6)

Background

81

(1)

Epidemiology

81

(1)

Anticoagulation in Patients with LV Dysfunction

82

(2)

Studies Suggesting No Benefit from Chronic Anticoagulation

82

(1)

Studies Suggesting Benefit for Long-Term Anticoagulation

83

(1)

Hemorrhagic Risk from Chronic Anticoagulation

83

(1)

Recommendations

84

(1)

References

85

(2)

9 Native and Prosthetic Valvular Heart Disease

87

(12)

Background

87

(1)

Mechanisms

87

(1)

Natural History of Thrombi

88

(1)

Prosthetic Heart Valve Thrombosis

88

(2)

Conditions

88

(1)

Bioprosthetic Heart Valves

89

(1)

Mechanical Heart Valves

90

(1)

Determining Thromboembolic Risk

90

(1)

Native Valvular Heart Disease

90

(1)

Prosthetic Valvular Heart Disease

90

(1)

Diagnosis of Valvular Thrombosis

91

(1)

Prevention of Valvular Thrombosis

92

(3)

Treatment of Valvular Thrombosis

95

(1)

References

95

(4)

10 Atrial Fibrillation

99

(8)

Background

99

(1)

Risk of Cardioembolic Stroke

99

(1)

Diagnosis

100

(1)

Echocardiography and Risk Stratification

101

(1)

Antithrombotic Therapy

102

(1)

Risk Stratification and Risk Reduction with Warfarin Therapy

102

(1)

Bleeding Risk with Anticoagulant Therapy

103

(1)

The Role of Platelet-Directed Therapy

103

(1)

Target Level of Anticoagulation

104

(1)

References

105

(2)

11 Peripheral Arterial Vascular Disease

107

(8)

Background

107

(1)

Thromboprophylaxis

107

(1)

Diagnosis

108

(1)

Cerebrovascular Disease

108

(1)

Peripheral Occlusive Disease

109

(1)

Acute Arterial Insufficiency

109

(2)

Peripheral Vascular Reconstructive Surgery

111

(1)

References

112

(3)

12 Periprocedural Management of Anticoagulants

115

(12)

Background

115

(1)

Current Guidelines

115

(2)

Estimation of Periprocedural Thrombotic Risk

117

(1)

LMWH and Periprocedural Anticoagulation Management

117

(8)

References

125

(2)

13 Anticoagulation Services and Coordinated Ambulatory Clinics

127

(14)

Background

127

(1)

Coordinated Anticoagulation Care

127

(2)

Risk Reduction with Coordinated Care

129

(6)

Cost-Effectiveness of Coordinated Care

135

(1)

Advances in PT Measurement: Patient Self-Testing

135

(2)

Home PT Monitor

137

(1)

References

138

(3)

Index

141

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Dx/Rx: Coronary Thrombosis

Summary

Table of Contents

Supplemental Materials