Comments on: Atrial Fibrilation – Blood Thinner Problem.?

By: Anonymous

Anonymous — Thu, 26 Nov 2009 17:52:57 +0000

Something doesn’t add up here. The risk of blood clots is life-threatening, but bleeding gums are just an annoyance – it doesn’t make any sense that you would put someone’s life at risk to avoid bleeding gums.
To sort this out, recognize that blood thinners do not actually make blood thinner – they reduce the ability of the blood to clot. The very last thing you want when a person has atrial fibrillation is to have blood start to clot inside the heart, so the blood has to remain “thinned.” Under these circumstances, having blood that is too thin is exactly what you want to have – that means she doesn’t need any medicine to prevent clotting. What doesn’t make any sense is why the docs would say on one hand that the blood is too thin, while at the same time saying that they can’t apply electrical shocks due to blood clot risk. These two conditions are mutually exclusive unless she has some type of blood disorder.
My advice is to ask the docs to explain this all to you again, and if you don’t get a satisfactory answer, take her to a different cardiologist ASAP.

By: purplegi

purplegi — Thu, 26 Nov 2009 14:41:41 +0000

I also suggest you ask for them to explain your wifes situation again as it doesnt really make sense. I am thinking you may have misunderstood some of the things happening and the reasons why.
If your wifes INR is too high she may get a bleed…usually for this to happen it would need to be way over the recommended range of around 2.5-3.5 possibly something closer to 8-10 for bleeding to occur and if it were that high they would treat it and get her back in-range. If it is too low she is in danger of throwing a clot and having a stroke which is much worse. You can replace blood but you cant replace brain cells.

By: Ben

Ben — Thu, 26 Nov 2009 10:15:34 +0000

I’m not sure why they won’t do an elective cardioversion for her Afib. The only contraindication that I know of for cardioversion due to Afib is if the tachycardia is either from poison or a drug OD. The reason they took her off the blood thinners is because if your gums are starting to bleed, then you risk internal bleeding in another part of the body, possibly the brain, which could cause a hemorrhagic stroke. The blood clots are caused because the blood is being churned up in her heart because her top chambers (atria) are almost quivering. I would definitely get a second opinion. You can have another cardiologist come and evaluate her in the hospital. If you do not feel comfortable with her leaving the hospital, then you need to say so. You can ask to speak to a patient representative or some type of family liaison to tell them your concerns.

By: LINDA B

LINDA B — Thu, 26 Nov 2009 07:21:42 +0000

Well, I am not an expert as far as the defibrillator. However, the matter of her coumadin level (blood test – PT), yes there is a way to make her blood “thick” that would be vitamin K. But, they will only use that if her PT results are extremely abnormal and I’m not sure that would be a wise idea because of the risk of blood clots. My mother was on chemo and it caused her coumadin to go completely off the charts. They gave her two units of fresh frozen plasma and within 24 hours her level was back in therapeutic range. Ultimately, I guess I really don’t have any suggestions, none that would make more sense then what her cardiologist has already tried. You could always ask for a second opinion. Your wife is a lucky lady to have you (and I am sure you feel equally blessed). Take care.

By: ckm1956

ckm1956 — Thu, 26 Nov 2009 06:46:59 +0000

The paramedic is wrong.
The reason they don’t want to shock her heart is that she’s likely been in AF and built up clots. Shocking (or chemically) converting such a patient is like asking for a stroke.
The ICD is designed to shock vfib, not afib. It would be rare for any device to be set to shock AF. If the device fires, it might kick a clot, but if it didn’t fire, she wouldn’t survive.
The problem with blood “thickeners” is that they directly counteract coumadin. It’s virtually impossibly to perfectly reverse someone.
You need to sit down with her cardiologist, lay out your concerns, and get answers.
Good luck.