Underuse of anticoagulation for atrial fibrillation - are we failing our patients?
Mavis is 78 years old and fiercely independent. She lives alone but has an active social life, particularly enjoying the Friday tea dance at her local village hall. She has high blood pressure and diabetes which are both well-controlled with oral medication. At Mavis’ annual blood pressure review, t...
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| Formato: | Journal article |
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College of Family Physicians of Canada
2017
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| Resumo: | Mavis is 78 years old and fiercely independent. She lives alone but has an active social life, particularly enjoying the Friday tea dance at her local village hall. She has high blood pressure and diabetes which are both well-controlled with oral medication. At Mavis’ annual blood pressure review, the nurse detects an irregularly irregular pulse and an electrocardiogram (ECG) confirms atrial fibrillation (AF) at a rate of 74 beats per minute. She sees her GP. He asks if she gets palpitations, shortness of breath or chest pain. Mavis hasn’t noticed any symptoms at all. Her GP reassures her that this is just an incidental finding and nothing more needs to be done. Three months later, Mavis is admitted to hospital with slurred speech and a sudden weakness in her left arm and leg. A CT scan confirms a large infarct in the right parietal lobe. Despite physiotherapy, she requires help to mobilise with a frame and get to the toilet. She is discharged to a nursing home one month after admission. |
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