Blood clots

[emjay]

Here is a question for the board . Im 15 days post op from a mitral valve repair 2days ago i had a episode with my left arm . I was reading a book I got up to get a drink as I stood up my left arm from my shoulder down to my hand started to hurt at least a #8 on pain my middle finger went white then blue needless to say I went to the ER. they did blood work ,CAT scan, TEE, regular echo ,the whole nine yards . No major blood clots found spent 2 days in the hospital.
I got home last night. this morning I went to reach for my oj on the table and I almost instantly went 80% blind in my right eye it only lasted for a minute. Doctors diagnosis some small clots are breaking up from the warfarin and travelling around. My levels are steady at 2.7 to 3.0
should I worry about a stroke, blindness . how long should this last ?
MJL

 

[Nancy]

It sounds like TIAs which are transient ischemic attacks. Joe's had many of them in the past. They are scary, and you should always go to the ER (do not drive yourself) when you have one, asap. If that is what it is, they will disappear within a short period of time.

But they have to be gotten under control and should not be ignored. There is some thinking that the aftereffects can accumulate.

They can also be a forerunner of a stroke.

So don't fool around with them. Go and get some help and testing.

 

[emjay]

Im outta here back to the hospital

 

[Mary]

Let us know what you find out.
My valve replacement surgery was pushed up after my last TIA in May. The valve was throwing flecks of calcium, and they were afraid I'd suffer a stroke. I've not had any problems since the replacement.
My thoughts are with you.
Mary

 

[ALCapshaw2]

Please be sure to report this to your Cardiologist, your Primary Care Physician, and maybe even your surgeon.

Patients that are at higher risk of clot formation are often advised to maintain a slightly higher INR, say 3.0 to 3.5 or maybe even 3.0 to 4.0. Discuss this with your cardiologist (or whoever is managing your Coumadin).

You may also want to ask your Cardiologist (and/or PCP) about chewing a full (325 mg) uncoated Aspirin whenever you experience such episodes. Aspirin is an anti-platelet drug and can help breakup a clot and prevent a stroke or heart attack.

'AL Capshaw'

 

[Guest]

The biggest risk factor for a stroke is having had a stroke already. The next biggest risk factor is having had a TIA.

 

[emjay]

Im back home there diagnosis was TIA im all thinned out and maxed out with warfarin , plavics and aspirin now the scary part . is it going to happen again. My surgeion was not happy with the plavics but it wieghed in as being better to take for a few weeks than not . Im almost scared to move or exersize etc... I do know that I have to be active and cautious MJL

 

[Nancy]

Plavix and aspirin, plus warfarin should do the trick. Joe was on Plavix for a while. He's not on it any longer.

As to whether it will happen again, no one can guess, but you are being protected the best way.

We have found that activity does not have anything to do with when or if they happen. So unless your doctor has restricted you, you should be OK to do your normal things. Take it easy for a week or so just to be sure.

I'm glad you got a diagnosis, and if anything unusual happens get someone to take you to the ER, or call 911.

They do not all manifest the same way.

Some of Joe's symptoms included blindness in one or both eyes, vision disturbances, temporary inability to do a simple task (winding up the garden hose), stabbing pain in the head, speaking unintelligible words or sentences, falling out of bed, sudden weakness and/or unsteadiness. All of these cleared up by the time the ambulance arrived, or shortly after.

They happened when anticoagulation was eithet out of range or in range. That didn't seem to make a difference. But Plavix makes the blood cells more slippery for better protection.

 

[Guest]

Warfarin, aspirin and Plavix increase the risk of bleeding slightly.

A TIA increases the risk of a clotting-type stroke greatly.

It is easier to get a little new blood than a little new brain. (Bleeds into the brain are pretty rare - clots in the brain are much more common)

 

[Mb]

Hello!

My husband had two TIA's, presurgery, pre coumaden. MRI's showed two brain infarcts, although most TIA's I understand do not show up on a MRI.

In January hs had a small stroke, and then in February he had a TIA (vision problems, lastly a couple of minutes). He has also had blue toe syndrome last summer. (thew small clots to his feet.) These events are three years post surgery. Dual valve replacement, chronic a-fib.

He is on coumaden and aspirin. With the exception of residual weakness in his left leg from the January event, none of these resulted in anything permanent.

Like Nancy, I saw not a thing that he did phyically that caused these issues. When he threw the microemboli to his toes, I did think at the time it was from his getting VERY VERY upset over something. Kinda lost his temper. He hasn't lost it since. Tries his best to keep calm.

Aside from taking the medications, there really isn't much you can do. The meds are the best prevention. And, if I were you, I would do my best to stay calm. - Marybeth