1. Is the PTT always used to monitor heparin therapy?
In a couple of situations, it is not. 1) When very high doses of heparin are used, as may occur during open heart surgery, the PTT loses its sensitivity; it will not clot. At this intense level of anticoagulation the Activated Clotting Time (ACT) is used as a monitoring tool instead of PTT. 2) Low molecular weight heparin (LMWH), which is a fast-acting form of heparin used in other treatment applications (such as deep vein thrombosis prevention), does not usually require monitoring.
2. Should everyone have their PTT checked?
This is not usually necessary. The PTT is not used as a routine general screening test. It is ordered when someone has symptoms of abnormal bleeding or clotting. Asymptomatic patients are occasionally screened prior to a surgery if their doctor feels that it will help evaluate their risk of excessive bleeding during the procedure.
3. How can I change my PTT?
The PTT is not something you can change through lifestyle changes (unless perhaps if you have a Vitamin K induced factor deficiency). It is a reflection of the integrity of your clotting system. If your PTT is prolonged due to acquired factor deficiencies, then addressing the underlying condition may bring the results to near normal levels. If they are prolonged due to a temporary or acute condition, they should return to normal on their own within a short time period.
