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CURRENT Diagnosis & Treatment: Cardiology, 3e
Chapter 29. Long-Term Anticoagulation for Cardiac Conditions
Sections: General Considerations, Pathophysiology & Etiology, Diagnostic Studies, Treatment of Cardiac Conditions Requiring Anticoagulation.
Topics Discussed: anticoagulation.
Excerpt:"Long-term anticoagulation is important in the treatment of many cardiac conditions. Intracardiac thrombi can form and lead to devastating consequences as a result of obstruction of blood flow and peripheral embolization.
Treatment for intracardiac thrombi involves the use of anticoagulants
for both primary and secondary prevention of thrombosis and embolization.
There are, however, risks associated with the use of these agents,
and an understanding of the risks and benefits of anticoagulant
therapy for various cardiac conditions is important.These agents affect the coagulation protein cascade to reduce thrombosis. Their greatest use is in primary and secondary prevention
of intravascular and intracardiac thrombosis and embolization.Unfractionated heparin (UFH) binds to antithrombin III, markedly
increasing the effect of antithrombin III in neutralizing thrombin.
It also inhibits the activation of factors IX and X. The effectiveness
of UFH varies greatly from person to person due to its interactions with
a number of plasma proteins and the endothelium. Monitoring the
effects of full dose UFH on hemostasis is mandatory. Routinely,
the activated partial thromboplastin time (aPTT) is used to monitor
the effects of UFH,..."
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