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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