Document Detail

Pacemaker lead thrombosis and disseminated intravascular coagulation following warfarin therapy: case report and review of the literature.
MedLine Citation:
PMID:  21478133     Owner:  NLM     Status:  MEDLINE    
A 54-year-old male with a permanent pacemaker was admitted to the intensive care unit due to a stroke. This occurred six days following the initiation of warfarin therapy for paroxysmal atrial fibrillation. The patient presented with profuse bleeding through the sites of venipuncture and laboratory evidence of disseminated intravascular coagulation. Echocardiography revealed multiple thrombi adjacent to the pacemaker leads. Underlying thrombophilia and/or any other systemic disorders were excluded. Thereafter, he exhibited multiple organ failure and despite all therapeutic efforts he expired. In the absence of any thrombophilia, the rare patient with a preexisting intracardiac device, in whom warfarin is prescribed, might experience thrombotic events. The latter could be linked with the preexisting device and/or could be triggered by the initiation of warfarin treatment, but this is merely a hypothesis.
John Papanikolaou; Andreas Karabinis; Triantafillia Koukoubani; Dimitrios Karakitsos; Epaminondas Zakynthinos
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē     Volume:  52     ISSN:  2241-5955     ISO Abbreviation:  Hellenic J Cardiol     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-04-11     Completed Date:  2011-09-22     Revised Date:  2013-08-07    
Medline Journal Info:
Nlm Unique ID:  101257381     Medline TA:  Hellenic J Cardiol     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  186-90     Citation Subset:  IM    
Intensive Care Unit, University Hospital of Thessaly, Larissa, Thessaly, Greece.
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MeSH Terms
Anticoagulants / adverse effects*
Atrial Fibrillation / complications,  therapy
Coronary Thrombosis / diagnosis,  etiology*
Disseminated Intravascular Coagulation / diagnosis,  etiology*
Middle Aged
Pacemaker, Artificial / adverse effects*
Stroke / etiology,  prevention & control
Warfarin / adverse effects*
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

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