CHANGES IN BLOOD COAGULATION FOLLOWING CORONARY THROMBOSIS MEASURED BY THE HEPARIN RETARDED CLOTTING TEST (WAUGH AND RUDDICK TEST) 12

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Abstract
A series of 16 control patients at absolute bed rest and 27 patients with coronary thrombosis were studied to determine if a tendency for accelerated coagulation of the blood occurs in the latter. The Waugh and Ruddick test was used; this consists in studying the coagulation time in a series of tubes of blood to which increasing quantities of heparin are added. The addition of heparin to the blood "decelerates" the coagulation of the blood and magnifies changes so that they can be more easily measured than by the usual methods. The control group consisted of 7 patients hospitalized for a variety of non-cardiac conditions and 9 patients with arteriosclerotic or hypertensive heart disease in various stages of congestive failure. The 27 cases of coronary thrombosis were selected by the usual diagnostic criteria. In both the control and the coronary groups, detns. were made 2 or 3 times weekly for 4 wks., then once a wk. until discharge or death. Observations were made more frequently during the 2d and 3d wks. in the coronary group and when complications ensued. While all 16 of the control group showed some acceleration of the coagulation on bed rest alone, usually beginning on the 3d day, none showed acceleration to the same degree as seen in coronary thrombosis. 77.8% of the cases of coronary thrombosis showed acceleration as measured by the Waugh and Ruddick test. This usually occurred by the 2d or 3d day and lasted to about the 17th day. Occasionally, acceleration was delayed until the 12th day or persisted only for several days. Acceleration was prolonged beyond the 3d wk. in a few cases. Such complications as a new coronary thrombosis, extension of the original thrombus, or pulmonary infarction developed in 5 patents when acceleration was already present, suggesting that this factor may be contributory. The findings suggest that the first attack is not initiated by accelerated coagulability of the blood in the avg. case, and that after the 4th wk. the clotting mechanism in coronary thrombosis is indistinguishable from the normal.