Which patients should be referred for a workup to rule out an inherited thrombophilia?
– Most patients with DVT’s have an obvious provocative risk factor present such as surgery, immobilization, cancer, etc. These patients are usually treated with a 3-6 month course of anticoagulation and do not require laboratory evaluation for thrombophilia. However, individuals with an inherited hypercoagulable disorder may require long-term anticoagulation. Because of that, patients presenting with any of the following features should probably be referred to a hematologist for evaluation to rule out thrombophilia: • A strong family history of arterial or venous thrombosis. • Personal history or family history of recurrent venous or arterial thrombosis. • Venous thrombosis in unusual sites (mesenteric veins, hepatic veins, dural venous sinuses, veins of the neck or upper extremities). • Initial arterial or venous thrombosis occurring before the age of 45-50 years – especially if no provocative risk factor is evident. • Women with thrombosis associated with oral contraceptives or pregn
