2020.10.17 08:15
2020.10.17 14:35
Further confusion we failed to clarify for almost one year now, Dr. Lee, is how much we should be aggressive on the preemptive strike with full anticoagulation especially to asymptomatic group! Indeed one of our German colleagues, Erika Mendoza of Wunstorf, is dying to get the full endorsement on this project from the vascular community - she applied for the funds to German government- through the year but no one was willing to share her enthusiasm on this preemptive strike so far, disappointing her!
BB Lee
2020.10.17 15:01
believe you are correct.
I've never seen any study or specific guidelines
in regard to anticoagulation regarding which anticoagulant, when,
by which route, oral, IV, SC or IM, how long etc.
I'm of the impression that the treating physician is using his or her clinical judgment.
Sometime ago I learned that at one of university hospitals they routinely order
sc heparin q 12 h on all patients being admitted to the hospital.
How much good it does, God only knows.
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Thrombi and microthrombi involving large and small vessels,
some with ST-elevation, AMI EKG findings yet negative coronary angiogram,
and some with a negative pulmonary angiogram
and no evidence of acute myocarditis by direct invasion by the virus
all speak loud about the importance of clotting causing the pathogenesis,
further emphasizing the importance of anticoagulation in those sick patients.