Hypercoagulable States

Chapter 63 Hypercoagulable States

Table 63-1 Classification of Hypercoagulable States

Table 63-2 Types of Inherited Antithrombin Deficiency

Table 63-3 Causes of Acquired Antithrombin Deficiency

Decreased Synthesis	Increased Consumption	Enhanced Clearance
Hepatic cirrhosis	Major surgery	Heparin
Severe liver disease	Acute thrombosis	Nephrotic syndrome
l-asparaginase	Disseminated intravascular coagulation
	Severe sepsis
	Multiple trauma
	Malignancy
	Prolonged extracorporeal circulation

Figure 63-1 THROMBOSIS THRESHOLD.

Genetic and acquired risk factors continue to determine an intrinsic risk for thrombosis for each individual. This risk is increased by extrinsic or environmental factors and decreased by thromboprophylaxis. If the intrinsic and extrinsic forces exceed a critical threshold at which thrombin generation overwhelms the protective mechanisms, thrombosis will result.

(From Anderson JA, Weitz JI: Hypercoagulability and uncommon vascular diseases. In Jaff MR, White CJ, editors: Vascular disease: Diagnostic and therapeutic approaches, Minneapolis, Minn, 2011, Cardiotext Publishing.)