The following are some of the more common procedures and medical conditions in which heparin is often used.

OPEN HEART SURGERY With heart surgery of any kind, including bypass and transplant, heparin is a standard therapy for a variety of purposes.

HEART ATTACK Heparin is used to treat heart attacks.

GENERAL HEART PATIENTS Heparin may be used therapeutically for heart patients, and it may also be used to avoid clots during the placement of stents (which can themselves be coated with heparin), and during heart catheterization procedure (which catheters also may be coated with heparin).

KNEE, HIP, OR JOINT REPLACEMENT AND ORTHOPAEDIC SURGERIES Heparin is a standard therapy given in advance of joint replacement surgery and after surgery to prevent blood clots from developing.

STROKE (blood clot in the brain) Heparin is used as a therapy in the treatment of stroke.

BRAIN ANEURYSM (blood leak in the brain) Subarachnoid hemorrhage (SAH) patients have a high exposure to heparin because they often have indwelling vascular catheters, and often undergo procedures using heparin in therapeutic doses. A recent Harvard study suggests that these patients are at grave risk for injury and death from HIT.

DEEP VEIN THROMBOSIS (DVT) AND OTHER THROMBOSIS Heparin is a standard treatment for DVT as well as other thrombosis.

PATIENTS UNDERGOING REGULAR IV THERAPY, INCLUDING DIALYSIS, CHEMOTHERAPY, PULMONARY HYPERTENSION PATIENTS, DIABETES, AND OTHERS Patients who are undergoing any regular IV or other invasive therapies are likely to be exposed to heparin, particularly heparin coated needles, heparin coated IV’s and heparin washes.

GENERAL MEDICAL PATIENTS Heparin has a number of ancillary uses that may not be documented in a patient’s medical record. Examples include heparin washes to maintain IV lines, heparin coatings on medical devices like catheters and needles, or heparin coatings on implanted medical devices.

TIME FRAME FOR ONSET OF HIT

Where a patient has not been previously exposed to heparin, HIT most often develops between days 5-10 from first exposure.

In patients previously exposed to heparin, typically within the last 100 days, “rapid onset” HIT can develop any time within the first 2 days from a new exposure to Heparin, and the HIT can be nearly immediate, within the first 30 minutes of a large dose in the form of an IV bolus.

The first signs of HIT can also be delayed for several days after cessation of heparin, and especially dangerous is the risk of life threatening thromboembolism (clots) that can occur up to several weeks after all heparin has been stopped.

CHECKLIST OF SYMPTOMS AND CONDITIONS FOR POSSIBLE HIT INJURY

SURGICAL AMPUTATIONS of toes, fingers, feet, hands, or limbs attributed to circulatory problems and where there has been any exposure to heparin.

HEART ATTACKS after undergoing a major medical procedure or hospitalization, or a second heart attack after use of heparin to treat a first heart attack.

STROKES after undergoing a major medical procedure or hospitalization or a second stroke after use of heparin in your treatment for a first stroke.

DEEP VEIN THROMBOSIS (DVT) after undergoing a major medical procedure or hospitalization or recurring clotting or thrombosis problems after use of heparin in your initial treatment for DVT.

PULMONARY EMBOLISM after undergoing a major medical procedure or hospitalization or recurrent thromboembolism (clots) after use of heparin in your treatment for thrombosis or embolism.

HEART BYPASS OR TRANSPLANT followed by the diagnosis of any of the conditions listed on this page, or where the recovery from heart bypass or transplant has been unexpectedly or unusually slow or delayed

ORGAN FAILURE OR ORGAN ISCHEMIA – Organ failure or organ “stroke” attributed to circulatory problems after undergoing a major medical procedure or hospitalization or after use of heparin in your treatment.

DEATH after undergoing a major medical procedure, hospitalization, or following the diagnosis of  any of the conditions listed on this page.

THROMBOCYTOPENIA - significant drop in platelet counts, usually 30-50% baseline or below 150,000 in association with current or recent exposure to heparin.

SKIN NECROSIS or SKIN LESIONS at heparin injection sites.

HEPARIN ANTIBODIES – a positive test for heparin antibodies.

LIMB ISCHEMIA – Limb ischemia is a deficiency of blood to the limbs due to an obstruction of circulation (clot) and can manifest as uncomfortable swelling, or limbs with bluish, mottled skin, or limbs that are cool to the touch.

GANGRENE – Death of tissue due to inadequate circulation or loss of blood supply  

NECROTIC ADRENAL GLANDS – Adrenal insufficiency or necrosis of the adrenal glands

THROMBOSIS or THROMBOEMBOLI – clotting and clots within the arteries or veins in any organ or part of the body