Should I be overly concerned?

My 46-yr old fiancee underwent two aortic dissections last spring (ascending valve in May and descending valve in August). He recuperated OK and returned to work in October. Last week when he visited the cardiologist, he was diagnosed with atrial fib. He was given coumadin to take and required to have blood drawn weekly to check his blood density (not sure that this is the correct way to say it). After taking coumadin for four days, his blood showed no change and he was instructed to increase dosage by 1/2 pill. I am really concerned about him because he currently lives alone, is 60 miles from a hospital and is 1300 miles away from me. Is this treatment sufficient for him? What are his chances of developing a blood clot, or having a stroke? How long will he have to take the coumadin?

[Michael J. McWilliams, M.D.]

Is this treatment sufficient for him?

Coumadin is recommended for people with several risk factors for stroke including previous stroke, hypertension, heart failure, age greater than 75, or diabetes.


What are his chances of developing a blood clot, or having a stroke?

It depends on their risk factor profile, typically between 2 and 8% per year.


How long will he have to take the coumadin?

Again, it depends on the risk factors.  Many people are on it for life.  It depends on their risk profile.