Multiple spontaneous hemorrhages after commencing warfarin therapy

SAGE Open Medical Case Reports
Nobuhiro Akuzawa, Masahiko Kurabayashi

Abstract

A 94 year-old Japanese woman with renal dysfunction was admitted to our hospital for congestive heart failure caused by atrial fibrillation with rapid ventricular response. Considering the risk of stroke, warfarin was commenced. However, she developed shock following brachial and retroperitoneal hemorrhage 4 days after starting warfarin despite not being over-anticoagulated. She recovered after receiving blood transfusion and intravenous vitamin K2. Bleeding during warfarin administration occurs more frequently in older individuals with lower glomerular filtration rates, especially within the first 30 days of warfarin treatment. Physicians should therefore check for unexpected bleeding after commencing warfarin and be prepared to reverse anticoagulation.

References

Jan 10, 2012·The Western Journal of Emergency Medicine·Meena ZarehSean Henderson
Dec 20, 2013·European Heart Journal·Laurent AzoulaySamy Suissa
Apr 17, 2015·Clinical Kidney Journal·Stephen HughesJecko Thachil
Aug 5, 2015·Journal of Thrombosis and Thrombolysis·Étienne Rouleau-MaillouxMarie-Pierre Dubé
Jul 15, 2016·Journal of the American Heart Association·Xiaoxi YaoPeter A Noseworthy
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group
Sep 10, 2016·Journal of the American College of Cardiology·Jan SteffelChristian T Ruff
May 16, 2017·The American Journal of Medicine·John FanikosPaul P Dobesh

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.