afib and mitral valve

[Sandy SHields]

I have a artificial heart valve. I have had it for 23 years. bjork shiley. I started having afib back in Oct. of last year. I have been cardio verted two times. I have converted on my own several times. My question is I went and had my INR checked to day and it was 1.7 to low. It is suppose to be between 2.5 to 3.5. I was wondering if there was anyone out there that might be able to tell me how big of risk am I of having a stroke if I go into afib while my blood is this thick and having a artificial valve. I read on the computer that people with artificial valves have a higher risk of stroke than a person that doen't even if they are on a anticoagulant. Sometimes I think I have a worry problem but I am not ready to go yet and I sure don't want to have a stroke. I do know that know matter how hard you try to prevent a stroke it can still happen. Just thought some one out there would have an answer.

 

[geebee]

I have a mechanical mitral valve and constant a-fib. My INR range is 3.0 - 4.0. As you know 1.7 is way too low - get it back up and fast. Yes, you are in more danger than if it were in range but short term won't be too bad. Normally I say not to worry about Vit. K content in food but this is one of those times to avoid Vit. K in any form. How long between tests do you wait?
What does you doctor say about the low INR?

 

[Sandy SHields]

afib Mechanical mitral valve and low INR

afib Mechanical mitral valve and low INR

Hi thanks for the answer. I haven't spoke with my Doctor it was a ARNP and she didn't really want to listen to me. I tried to tell her about my problems and why I was taking such a small dose of coumadin but she didn't want to listen. Shew just told me to increase my dosage for a couple of days then go back to my normal dosage. It kinda irritates me when they act that way because I have bee on coumadin for 23 years and I know how I react to it. I am on Rythmol 475mg twice a day and in the beginning it made my INR run at 4.5 ao my Dr. put me at 2.5 a day I have never taken that small of a dose. So i really think I need to be on 2.5 four times a week and 5 mg 3 times a week. Anyway I just pray I don't go into afib while it is at this level.
Thanks again.

 

[ALCapshaw2]

Welcome Sandy,

A GREAT source of information on Coumadin Management can be found at www.warfarinfo.com which is the website of Al Lodwick, a Registered Pharmacist and certified anticoagulation specialist who runs a Coumadin Clinic in Pueblo Colorado. He frequently monitors the Anticoagulation Forum on VR.com and will answer questions on the forum, via Private Mail, or e-mail.

I highly recommend that you buy his Dosing Guide ($5) which can be ordered through his website.

Given that you have a mechanical valve in the Mitral Valve position, I would suggest asking your Cardiologist if it wouldn't be wise to raise your INR target range from 3.0 to 4.0 (the same as Gina's) to some additional safety.

The risk of bleeding 'usually' doesn't rise until INR is above 5.0 and many have reported an INR of 8.0 with NO bleeding. The risk of Stroke rises when INR is below 2.0 as you seem to already know. Lovenox injections are sometimes used to minimize risk when going OFF Coumadin for invasive procedures or if your Doctor is concerned about stroke risk with a low INR.

Hopefully Al Lodwick will see your post and add his recommendation. OR, you could send him a personal note to get his expert advice.

'AL Capshaw'