Heparin-induced thrombocytopenia physical examination: Difference between revisions

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===Skin Exam===
===Skin Exam===
* Skin necrosis from thrombotic physiology<ref name="pmid22315270">{{cite journal| author=Linkins LA, Dans AL, Moores LK, Bona R, Davidson BL, Schulman S et al.| title=Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e495S-e530S | pmid=22315270 | doi=10.1378/chest.11-2303 | pmc=3278058 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315270  }} </ref>
* Skin necrosis from thrombotic physiology<ref name="pmid22315270">{{cite journal| author=Linkins LA, Dans AL, Moores LK, Bona R, Davidson BL, Schulman S et al.| title=Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2012 | volume= 141 | issue= 2 Suppl | pages= e495S-e530S | pmid=22315270 | doi=10.1378/chest.11-2303 | pmc=3278058 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22315270 }} </ref><ref name="pmid24992313">{{cite journal| author=McKenzie SE, Sachais BS| title=Advances in the pathophysiology and treatment of heparin-induced thrombocytopenia. | journal=Curr Opin Hematol | year= 2014 | volume= 21 | issue= 5 | pages= 380-7 | pmid=24992313 | doi=10.1097/MOH.0000000000000066 | pmc=4232774 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24992313 }} </ref>
* Petechiae from thrombocytopenia
* Petechiae from thrombocytopenia
* Purpura from thrombocytopenia
* Purpura from thrombocytopenia

Revision as of 20:59, 1 August 2017

Heparin-induced thrombocytopenia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Shyam Patel [2]

Overview

The physical exam for HIT focuses on the skin, pulmonary, and musculoskeletal exam. These are the common areas of thrombotic manifestations. Bleeding can also occur in these organs. A complete physical exam can help with evaluation of thrombosis or bleeding in other organs.

Physical Examination

Skin Exam

  • Skin necrosis from thrombotic physiology[1][2]
  • Petechiae from thrombocytopenia
  • Purpura from thrombocytopenia
  • Ecchymoses from thrombocytopenia

Cardiopulmonary Exam

  • Tachypnea from pulmonary embolism
  • Tachycardia from pulmonary embolism
  • Hypoxia from pulmonary embolism

Musculoskeletal Exam

  • Leg swelling from deep vein thrombosis[1]
  • Calf tenderness from deep vein thrombosis

Other Exam Findings

  • Mucosal bleeding from thrombocytopenia (i.e. oral, nasal, urinary, menstrual, gastrointestinal, or other)
  • Abdominal tenderness from mesenteric venous thrombosis
  • Neurologic deficits from cerebral arterial or dural venous sinus thrombosis

Reference

  1. 1.0 1.1 Linkins LA, Dans AL, Moores LK, Bona R, Davidson BL, Schulman S; et al. (2012). "Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e495S–e530S. doi:10.1378/chest.11-2303. PMC 3278058. PMID 22315270.
  2. McKenzie SE, Sachais BS (2014). "Advances in the pathophysiology and treatment of heparin-induced thrombocytopenia". Curr Opin Hematol. 21 (5): 380–7. doi:10.1097/MOH.0000000000000066. PMC 4232774. PMID 24992313.

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