Reintroducing Anticoagulant After Stroke
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Reintroducing Anticoagulant After Stroke
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Recently we had a patient with AF and multivalvular disease who was admitted with stroke. I wonder when is the best time to reintroduce warfarin after an acute stroke with cerebral infarctio
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Forums » Open clinical » Stroke » Reintroducing Anticoagulant After Stroke
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Reintroducing Anticoagulant After Stroke
posted at 5/2/2012 11:50 AM GMT
on bmj.com
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Posts: 2
First: 5/2/2012 Last: 8/2/2012 |
Recently we had a patient with AF and multivalvular disease who was admitted with stroke. I wonder when is the best time to reintroduce warfarin after an acute stroke with cerebral infarction. And do we have to cover the patient with heparin until INR is theraputic or just to continue on aspirin. Your ideas are highly appreciated |
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Re: Reintroducing Anticoagulant After Stroke
posted at 5/2/2012 5:42 PM GMT
on bmj.com
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Posts: 152
First: 17/12/2011 Last: 20/5/2012 |
Depends upon how ill and frail paitient is and what the patients wants. It can be difficult conveying risk to a patient with out biasing the information to what you as the Doctor thinks is best for the patient. I tend to think , 'what would I want if I were the patient or it was my , father , mother sister or other relatives'. But I accept that different patients will accept different grades of risk, I used to climb a lot and still ride a large motorcycle at 61yo, so I have to we aware that most people might take less risks than I might for my self. On balence as I understand it Warfarin and monitoring is the best teatment for reducing risks in AF , statins also seem to help, and keeping BP low, ACE or ARBs and pulse rate control, , Asprin if warfarin not acceptable. Mind you it is all to over medicalise old age. |
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Re: Reintroducing Anticoagulant After Stroke
posted at 8/2/2012 8:36 PM GMT
on bmj.com
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Posts: 2
First: 5/2/2012 Last: 8/2/2012 |
Thanks Pat Lush for your contribution. Actually the patient I was talking about is in her early 50th and the multivalvular disease was as a result of rheumatic heart disease rather than IHD. In developing contries, we do still see many young patients with similar problem. I think you were right regarding consent which would be a big issue especially if the patient is dysphasic. However we have to consider the best interest of the patient or put yourself in their place and think what would be best for you |
Forums » Open clinical » Stroke » Reintroducing Anticoagulant After Stroke
