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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could Swollen Ankles With Bruises With History Of A Fib And Heart Ablation Be Blood Clots?

My husband, age 66 and currently taking Xarelto 20mg and Tikosyn 125 mcg for previous Afib condition. He had heart ablation procedure done in March 2014 and has been in normal heart rhythm since. He has been taking Xarelto for approx 1 year and began the Tikosyn after the ablation procedure in March. Last weekend he played in a senior softball tournament where he slid into home base to avoid being out. He has large abrasions on the back of his left thigh as well as his left knee and calf. Tonight both of his ankles are swollen and has bruising on both sides of his right foot. Should we be concerned about blood clots or could there be something else going on? He says he has no pain in the ankles or feet and heart rhythm seems normal.
Wed, 3 Sep 2014
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Psychiatrist 's  Response
Hi welcome to HCM.
Lonterm anticoagulation with Xarelto and Tikosyn is usually associated bleeding manifestaions as their predominant side effects.This is due to Warfarin induced inhibition of clotting factor synthesis.This can manifest in the form of prolonged bleeding as subcuatenous bruises during minor trauma.This can be prevented through periodic monitoring of PT/INR,which should be maintained in between 2-3.Treatment includes dose reduction of anticoagulants.In refractory cases Fresh frozen plasma can be given.Consult your cardiologist for further queries.
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Could Swollen Ankles With Bruises With History Of A Fib And Heart Ablation Be Blood Clots?

Hi welcome to HCM. Lonterm anticoagulation with Xarelto and Tikosyn is usually associated bleeding manifestaions as their predominant side effects.This is due to Warfarin induced inhibition of clotting factor synthesis.This can manifest in the form of prolonged bleeding as subcuatenous bruises during minor trauma.This can be prevented through periodic monitoring of PT/INR,which should be maintained in between 2-3.Treatment includes dose reduction of anticoagulants.In refractory cases Fresh frozen plasma can be given.Consult your cardiologist for further queries. Thank you