About: In prep
- Cerebral venous sinus thrombosis: Persistent or severe headaches, seizures or focal neurology
- Splanchnic vein thrombosis
- Pulmonary embolism : Shortness of breath, persistent chest
- Arterial ischaemia : Swelling, redness, pallor or cold lower limbs
- Bleeding can be significant and unexpected.
- If day 4-28 and platelets normal then VITT unlikely
- if platelets < 150 x 109 /L then send Dimer 1D Dimer as mcg/L, (includes FEU or DDU) = 2mg/L (cases -D Dimers > 4000 mcg/L but D Dimers 2000-4000 mcg/L need to be discussed as probable case) Does the patient have symptoms of another clinical condition that needs investigation If N then home with safety net advice to return if persistent or escalating symptoms or other concern for thrombosis for repeat testing If Y then further work up required for alternative diagnoses Send clotting (fibrinogen) and d-dimer tes