Evaluation of recurrent thrombosis and hypercoagulability.

The primary mechanisms for coagulation were described more than a century ago. However, inherited disorders of coagulation have been recognized for only a few decades. Activated protein C resistance and other related protein defects account for many cases of hypercoagulability. Primary care physicians can initiate testing in individuals for whom there is a high degree of suspicion. Testing for specific disorders is best performed before initiation of anticoagulant therapy. Management often includes long-term warfarin therapy following initial anticoagulation with heparin.