Heparin/warfarin/vitamin K antagonists
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Multiple infarctions and pulmonary thromboembolism: 2 case reports In a case report, two patients were described, out of whom, a 45-year-old man developed acute inferior myocardial infarction due to embolisation of the left ventricular thrombus (LVT) during treatment with heparin and unspecified vitamin K antagonists, and a 35-year-old man developed cerebral, renal and splenic infarctions with pulmonary thromboembolism during treatment with heparin and warfarin [routes, dosages, duration of treatments to reactions onsets and outcomes not stated]. This report describes a 45-year-old man (case 1): The man was diagnosed with LVT with a low ejection fraction. He was started on conventional therapy with heparin [unfractionated heparin] and unspecified vitamin K antagonists for the LVT. However, the conventional therapy resulted in an acute inferior myocardial infarction secondary to embolisation of the LVT. This report describes a 35-year-old (case 2): The man was diagnosed with left ventricular/left atrial/right ventricular thrombus with decreased ejection fraction. He was started on conventional therapy with heparin [unfractionated heparin] and warfarin. However, the conventional therapy resulted in renal infarction, cerebral infarction, splenic infarction and pulmonary thromboembolism. Author comment: "Conventional therapy (unfractionated heparin combined with vitamin K antagonists) for the LVT resulted in an acute inferior myocardial infarction due to an embolisation of the LVT." "Conventional therapy [unfractionated heparin and warfarin] resulted in a cerebral infarction, renal infarction, splenic infarction and pulmonary thromboembolism (PTE)." Nakamura S, et al. Effectiveness of direct oral anticoagulants with initial intensive therapy for a giant thrombus swivelling in the right atrium. BMJ Case Reports 12: No. 11, 25 Nov 2019. Available from: URL: http://doi.org/10.1136/ 803443680 bcr-2019-233174 - Japan
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Reactions 4 Jan 2020 No. 1785
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