Raised international normalized ratio: an early warning for a late cardiac tamponade?
Ammad Shah1, Albert van den Brink, Bas de Mol
1Academic Medical Center, Amsterdam, The Netherlands. a.shah@amc.uva.nl
Abstract:
Seven consecutive cases of late cardiac tamponade after valvular surgery are reported; all were postoperatively treated with acenocoumarol and 6 had an international normalized ratio peak greater than 6.0 within 3 days preceding tamponade. It is suggested that during this excessive anticoagulation state a hemorrhagic event within the pericardial space precipitates the tamponade. In addition, it is proposed that all valve patients with a postoperative international normalized ratio peak greater than 5.0 within 6 weeks postoperatively should be considered for a transthoracic echocardiogram.
Related Concept Videos
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Acute Coronary Syndrome III: Diagnostic Studies
Rheumatic Heart Disease IV: Nursing Management
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Pericarditis IV: Nursing Management
