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Suggest Treatment For Dehydration, Arrhythmia And Atrial Fibrillation
Question: Became dehydrated, arrhythmias very fast. Whilst I hospital were put on injections to replace warfarin. Upon return was left four days with no anticoagulants then placed on aspirin 7.5 mg tablets one daily. I am concerned as would have preferred rivaroxaban to replace warfarin. Why would this choice have been made? Already have had T.I.A.S and diagnosis of vascular dementia without having been allowed an MRI scan, which was requested and refused even when offered to pay privately. Atrial fibrillation as well controlled by diltiazem effective before but since being on aspirin has led to lowered blood pressure and dizziness. I feel this change of medication not to my benefit but placed now at higher risk of DVT as currently bed bound and higher risk of stroke or T.I.A'S.. Please advise me, 69 years old. I have photosensitivy and can't see since an episode in December last year and since commencing tamsulosin and finasteride
Brief Answer:
Rivaroxaban would be a better therapy in your case
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern and I would say that, from what you refer, it seems you have had a coagulation imbalance which was the cause of warfarin interruption.
I would like to explain that referring to your past medical history, you are at a high risk for cardioembolic events ( CHAD2DS2 score>2) and anticoagulation therapy is prior to aspirin in your case.
I agree with you in the fact that rivaroxaban would be a better therapy than aspirin in your case for the prevention of cardioembolic events in the future (considering that warfarin can not be used).
From the other hand, the possible interactions between diltiazem and rivaroxaban should be taken into consideration. Diltiazem can increase rivaroxaban plasmatic levels leading to a higher risk of hemorrhage. I would advise a close monitoring when combined together. You should discuss with your attending physician for a possible substitution of diltiazem to another therapy.
Another issue to consider when taking rivaroxaban is the kidney function, because it is known that rivaroxaban is excreted in the urinary ways.
So I would advise to perform kidney function tests before starting and during treatment with rivaroxaban.
Regarding the MRI it results usually normal in TIA, and a normal MRI would confirm this diagnosis.
Hope to have been helpful!
I am at your disposal for further questions whenever you need!
Best wishes,
Dr.Iliri
Rivaroxaban would be a better therapy in your case
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern and I would say that, from what you refer, it seems you have had a coagulation imbalance which was the cause of warfarin interruption.
I would like to explain that referring to your past medical history, you are at a high risk for cardioembolic events ( CHAD2DS2 score>2) and anticoagulation therapy is prior to aspirin in your case.
I agree with you in the fact that rivaroxaban would be a better therapy than aspirin in your case for the prevention of cardioembolic events in the future (considering that warfarin can not be used).
From the other hand, the possible interactions between diltiazem and rivaroxaban should be taken into consideration. Diltiazem can increase rivaroxaban plasmatic levels leading to a higher risk of hemorrhage. I would advise a close monitoring when combined together. You should discuss with your attending physician for a possible substitution of diltiazem to another therapy.
Another issue to consider when taking rivaroxaban is the kidney function, because it is known that rivaroxaban is excreted in the urinary ways.
So I would advise to perform kidney function tests before starting and during treatment with rivaroxaban.
Regarding the MRI it results usually normal in TIA, and a normal MRI would confirm this diagnosis.
Hope to have been helpful!
I am at your disposal for further questions whenever you need!
Best wishes,
Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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