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October 11, 2004

Heparin-Induced Thrombocytopenia: Myths and Misconceptions (That Will Cause Trouble for You and Your Patient)

Arch Intern Med. 2004;164(18):1961-1964. doi:10.1001/archinte.164.18.1961

Heparin-induced thrombocytopenia (HIT) precipitates an extreme prothrombotic diathesis, with 50% of patients presenting with complicating venous or arterial thromboemboli.1 Without prompt and effective treatment, the likely outcome is limb amputation in 10% to 20%, death in 20% to 30%, and residual deficits in survivors related to strokes, myocardial infarctions, and pulmonary emboli.2,3 Those without a thrombus on presentation (isolated HIT) have a risk approaching 50% of developing one and suffering a similar outcome.1,4 Key to preventing catastrophes is awareness, vigilance, and the application of recently refined treatment strategies. From managing many hundreds of cases over 25 years and frequently discussing this topic nationwide, I seek to expose persistent myths and misconceptions that impede life- and limb-saving care for patients with HIT.