Author: Sandy Brundage (OSU Medical Student Class of 2019) // Editor: Michael Barrie (OSU EM Assistant Professor)
A 56-year old woman presented to the ED for acute onset of shortness of breath with unilateral left leg swelling. PMH significant for a total knee replacement five days ago. Current medications include aspirin, lisinopril, metformin, labetalol and enoxaparin. CBC comes back with a platelet count of 30,000. Upon reviewing her chart, you notice that her platelet count prior to the surgery was 250,000. A lower extremity doppler confirms an acute deep venous thrombosis.
What is contributing to the development of thrombosis despite her medications and thrombocytopenia?