In this episode, Drs. Ronak Mistry and Jori May discuss the challenging decision of when to test for inherited thrombophilias and how results inform anticoagulation management. The use of thrombophilia testing has long been debated in the hematology community, due in large part to limited data and the complexity of estimating recurrent thrombotic risk. Through the case of a 36-year-old woman with a proximal deep vein thrombosis 4 weeks after an uncomplicated vaginal delivery, we explore the importance of defining provoking factors, evaluating bleeding risk, exploring previous thrombotic challenges and family history, and ultimately whether thrombophilia testing may be helpful to determine the need for long term anticoagulation.
Learning Objectives:
- Accurately interpret the results of laboratory tests for inherited hypercoagulable disorders.
- Identify appropriate clinical situations where testing for inherited hypercoagulable disorders can be considered.
- Discuss how inherited thrombophilias influence decisions on the duration of anticoagulation in VTE without major transient risk factors.
Clinical Pearls:
- Assay selection, appropriate timing of testing, and accurate interpretation of results are foundational to the use of thrombophilia testing in the care of patients with VTE.
- The use of thrombophilia testing to guide the duration of anticoagulation in patients with VTE without major transient risk factors is debated and therefore must be individualized to every patient.
What is HemeTalks: Conversations in Hematology Education?
HemeTalks: Conversations in Hematology Education is an American Society of Hematology (ASH) podcast for community hematologists, advanced practice providers, and trainees. Through engaging storytelling and case-based discussions with guests ranging from early-career professionals to leading experts, the podcast offers practical strategies that make complex hematology topics accessible and relevant at every career stage. Its mission is to support the educational needs of its audience through high-quality, clinically focused content.