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| Year:
2026 |
Month:
April
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Volume:
15 |
Issue:
2 |
Page:
PC01 - PC03 |
Therapeutic Venesection in Patient of Pulmonary Thromboembolism on Heparin: A Case Report
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Correspondence
Aishwarya Ajith, R Krishnamoorthy, A Ashwin, M Sampat Kumar, R Niranj Rathan,
R Niranj Rathan,
Sri Ramachandra Medical College and Research Institute, Porur,
Chennai-600116, Tamil Nadu, India.
E-mail: dr.aishwaryaajith@gmail.com :
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Therapeutic venesection is a cornerstone in the management of polycythaemia to reduce hyperviscosity and thrombotic risk. However, its application in patients receiving anticoagulation, particularly heparin, is complex due to the potential for bleeding complications. The current case report describes a 40-year-old male who presented with progressive breathlessness, fatigue, and pedal oedema. Laboratory investigations revealed polycythaemia with elevated haemoglobin and haematocrit levels. The patient was diagnosed with acute pulmonary thromboembolism and severe pulmonary artery hypertension. He was initiated on unfractionated heparin therapy. Due to persistent symptoms and hyperviscosity, therapeutic venesection was performed after temporarily withholding heparin. A total volume of 450 mL of blood was removed. The procedure was well tolerated, with stable vital signs, and the patient showed symptomatic improvement following venesection. The present case highlights the therapeutic benefit and safety of venesection in a patient with polycythaemia and pulmonary thromboembolism receiving anticoagulation. Meticulous risk assessment, temporary cessation of anticoagulation at the time of venesection, and strict procedural monitoring were critical in preventing complications. A multidisciplinary approach ensured optimal patient outcomes. The novelty of the current case lies in the successful integration of therapeutic venesection in a high-risk anticoagulated patient, guided by an individualized risk-benefit assessment and coordinated multidisciplinary management to optimise safety and outcomes in complex thrombotic scenarios.
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