Raised international normalized ratio: an early warning for a late cardiac tamponade?

Shah, Ammad; van den Brink, Albert; de Mol, Bas · Ann Thorac Surg · 2006

case_report · Level V

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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.

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