What Is The Cause And Treatment For Atrial Fibrillation?

Posted on Wed, 11 Feb 2015

Question: Husband is 75, hepatitis C, transplant in 2000, I had a heart murmur that the cardiologist said was aortic's to gnosis 2/4, and had afib on Monday morning while fasting for bloodwork after being very dehydrated from social outings on Sunday which included wine and coffee. He's not diabetic has no history of heart disease, he didn't have the veins in his legs fixed, is not fat, and is fairly healthy. The only drug he really takes is antirejection drugs, Prograf. Was cardiologist said he scored 3.2 on the latest XXXXXXX and wants to put him on Coumadin. I see it's an isolated incident and agreed to put them on a monitor for a month and make several needed lifestyle change as which include no wine no coffee no chocolate regular meals, and hydration.

Answered by Dr. Prakash H Muddegowda (2 hours later)

Brief Answer:
Will require anticoagulation therapy

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. XXXXXXX score of 3.2 is high enough, so that warfarin needs to be started.
2. Score of more than 2.0 requires warfarin coagulation. INR during warfarin therapy needs to be maintained between 2-3.
3. If you are against warfarin therapy, which is necessary, at least he needs to be started on aspirin. Which might help, but not advisable.
4. Even without symptoms of fib, his score will be more than 2, which will require anticoagulation therapy. Also additionally age is another independent risk factor.

If he were my patient, I would strongly recommend anticoagulation therapy.

Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prakash H Muddegowda (4 hours later)

Have you looked at the side effects of Coumadin? Shortness of breath... I do not believe it is recommended for lover patients. His prograf makes him mg deficient. Did you think he may be mg deficient? Did you consider monitoring the pt with a heart monitor for a month because he is a symptomatic and had consumed wine, coffee the day before and was fasting for bloodwork and dehydrated when it occurred? Are you listening to the pt, or is it just easier to prescribe a drug?

Answered by Dr. Prakash H Muddegowda (8 hours later)

Brief Answer:
Needs anticoagulation therapy

Detailed Answer:
Hi,
Thanks for asking again.

1. Aspirin is low dose and is contraindicated in liver failure. I assume his liver function is good.
2. The choice was secondary as the primary anticoagulation therapy could not be followed.
3. I am all for against medication and life style modification would be top priority. However, given the high score, I had rather start a medication than risk a critical condition, which at this age worsens further and risk of cognition or function deterioration would be high.

Do think once again.
Hope it helps.
Any further queries, glad to help again.

Dr. Prakash HM

Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar