Wednesday, April 23, 2014
Bleeding and Clotting Disorders
Factor V Leiden-long term coumadin usage
When my 25 yr-old daughter was 18, she had a left subclavian DVT and testing at that time revealed she is heterozygous for factor v leiden. She was treated with Heparin in the hospital; has been on Coumadin ever since with no more DVT`s. Does she need to continue on coumadin? Also, if she became pregnant would she need to take heparin injections during the pregnancy?
It is difficult to answer specific questions about your daughter's case without being able to see her, examine her, and go over all her records.
I would say though that the decision to stop or continue the warfarin may depend on why she had the clot in the first place. It is very strange to have a clot in the subclavian vein, especially without either a central line being placed on the same side, or several other anatomical problems (cervical ribs, thoracic outlet syndrome, or other anatomical abnormality causing a stenosis or narrowing of the vessel) that can predispose to getting a clot in that large vein.
I would tell you to discuss these questions with the doctor taking care of you daughter to get a better handle on how long she needs to be treated for.
Spero R Cataland, MD
Associate Professor of Clinical Internal Medicine
College of Medicine
The Ohio State University