Gude, DilipAbbas, AslamMohiuddin, Hina2013-03-042013-03-042013-01Gude Dilip, Abbas Aslam, Mohiuddin Hina. When blood is thinner than water. Annals of Cardiac Anaesthesia. 2013 Jan; 16(1): 63-65.http://imsear.searo.who.int/handle/123456789/145397Antagonists of vitamin K dependant clotting factors are commonly used as treatment/prophylaxis for anticoagulation. Due to their narrow therapeutic window, a wide range of complications including death may occur. International normalized ratio (INR) is monitored to measure adequacy/excess of anticoagulation. There is a plethora of risk factors that may contribute to the uncontrollably high INR values. We describe our experience of a case of deep venous thrombosis wherein the patient had an overshoot of INR during anticoagulation therapy. We review the literature and discuss management in such scenarios.enAnticoagulationBleedingInternational normalized ratioBlood Coagulation --drug effectsBlood Coagulation --prevention & controlBlood Coagulation Disorders, Inherited --prevention & controlBlood Coagulation Factors --drug effectsHumansInternational Normalized Ratio --statistics & numerical dataVitamin K --antagonists & inhibitorsArticle