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Heart Disease (Expert Forum)
Complications from long term anticoagulant therapy
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Complications from long term anticoagulant therapy
by L-Keown, Jan 14, 1999 12:00AM
What is the prognosis for recovery for my sister? I understand that anticoagulant therapy is necessary, but it seems to be wrecking her heatlh. Here's a brief description.
-My sister had a mitral valve replaced approx 18 years ago. She has been dealing with increasingly more serious complications with anticoagulation therapy. It has been extremely difficult to keep the PT or INA in the recommended range. It's been worse the last few years.
-Presently 49 years of age. Short-med height, 20-30 lbs overweight, not physically active.
-Valve replacement advised..she is afraid. Existing valve Bork Shiley (sp?)
-Multiple eposides in the last 10 years of temporary loss of vision due to clots, some permanent vision loss (>50% area of one eye, <20% other eye).
-PT and INA swings radically in both directions out of range.
-Hysterectomy 2 years ago due to uncontrollable hemorrhaging.
-Admitted to hospital 5 days ago with cranial bleed and bleeding in right eye. Quickly diagnosed and operated on locally. This was preceeded by a large bloody spot under the skin of one arm (2 weeks prior)accompanied by pain and partial loss of function. PT and INA tested at least weekly during this time. I do not know about medication adjustments.
-Some brain tissue removal around the right temple. She started speaking yesterday. Is able to answer questions requiring logic and memory. No control over left arm and leg. Starting to have tingling/pain in left arm and leg today.
-They will not resume anticoagulant therapy until they feel it is safe..probably in the next couple of days.
-My sister had a mitral valve replaced approx 18 years ago. She has been dealing with increasingly more serious complications with anticoagulation therapy. It has been extremely difficult to keep the PT or INA in the recommended range. It's been worse the last few years.
-Presently 49 years of age. Short-med height, 20-30 lbs overweight, not physically active.
-Valve replacement advised..she is afraid. Existing valve Bork Shiley (sp?)
-Multiple eposides in the last 10 years of temporary loss of vision due to clots, some permanent vision loss (>50% area of one eye, <20% other eye).
-PT and INA swings radically in both directions out of range.
-Hysterectomy 2 years ago due to uncontrollable hemorrhaging.
-Admitted to hospital 5 days ago with cranial bleed and bleeding in right eye. Quickly diagnosed and operated on locally. This was preceeded by a large bloody spot under the skin of one arm (2 weeks prior)accompanied by pain and partial loss of function. PT and INA tested at least weekly during this time. I do not know about medication adjustments.
-Some brain tissue removal around the right temple. She started speaking yesterday. Is able to answer questions requiring logic and memory. No control over left arm and leg. Starting to have tingling/pain in left arm and leg today.
-They will not resume anticoagulant therapy until they feel it is safe..probably in the next couple of days.
Doctor's Answer
by CCF Cardio MD - MTR, Jan 14, 1999 12:00AM
Dear L, thank you for your question. It appears that your sister has suffered a stroke from the intracranial bleeding. I can't answer the question about her prognosis since it's too early to tell and I'm not her physician. However, you should certainly ask that question to her physicians at this point. Unfortunatley, coumadin/warfarin is not an easy drug to manage since people respond to this medication in vastly different ways. Some patients stay within the recommended therapeutic range all the time and others vacillate between "highs" and "lows" like your sister. We can't predict who this may happen to and once it does happen, it's difficult to treat. My regards to you and your family and best wishes for your sister.
I hope you have found this information useful. Information provided in the heart forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physicians. Please feel free to write back with additional questions. If you would like to make an appointment at the Cleveland Clinic Foundation, please call 1-800-CCF-CARE. Good luck!
