Case 64 – part 1b

The patient with abnormal clotting resulst goes ahead with his planned pacemaker insertion. There is no major bleeding during the procedure but afterwards there is a large haematoma around the pocket with extensive bruising.


Repeat clotting screen shows:

  • PT 14s (11-14s)
  • APTT 47s (33-40s)
  • APTT 50:50 mix immediate 38s
  • APTT 50:50 mix at two hours 37s
  • Thrombin time 16s (15-19)
  • Fibrinogen (Clauss) 6.4g/L (1.5-4.5g/L)



  • Can you explain the results?
  • What are the possibilities?
  • Any further testing needed?


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