TEE and coumadin

Dee · Nov 23, 2004

I'm having a TEE done on Mon. and they told me to not take my coumadin for 4 days prior. Is that the norm??? My first TEE was done before my OHS and I wasn't on coumadin at that time. 4 days seems like a lot to me, my INR drops like a rock after skipping just one day. I also posted this in the Heart Talk section....but thought this might be a more appropriate place.

I appreciate any of your input.

Ross · Nov 23, 2004

That's just plain insane nuts! Wall of shame material to the max! There is no bleeding involved with a TEE. There is no reason whatsoever to be even reduced on Coumadin. Utter B.S. once again. I think you need to find a new physician and fast, this one or these are going to kill you.

Dee I don't mean to sound like I'm yelling or scolding you, but this has got to be the poorest excuse I've heard yet for stopping Coumadin.

geebee · Nov 23, 2004

Dee,
I agree with Ross. It's just plain stupid to endanger you with going off Coumadin for a TEE. Unless the person doing the TEE is an idiot and manages to gouge your throat, where would the bleeding danger come from? You definitely need to rethink working with whoever recommended going off Coumadin.
Sorry to be so blunt but this kind of thing really irritates me. I can't believe there are still doctors out there that think this way. I have a cardio who actually did a cardica cath without taking me off Coumadin because I was having so many problems with TIAs so, a TEE can certainly be done while on Coumadin.
Smiles,

Gina

ALCapshaw2 · Nov 23, 2004

There IS a middle ground and that is to have BRIDGE THERAPY when going off Coumadin.

You take either Lovenox injections or a Heparin Drip for 3 or 4 days BEFORE AND AFTER the procedure, stopping around 8 hours before the procedure and restarting shortly after the procedure (the DOC should set the timing). A Heparin Drip requires hospitalization (yep, you will be in the hospital for a week spinning your wheels).

You may also want to request an upper endoscopy to be sure the (larger) TEE probe will pass without stretching (tearing) your esophagus. (I've had BOTH, more than once! My upper endoscopies were for REFLUX issues.)

'AL'

tobagotwo · Nov 24, 2004

For whatever assistance it may provide you...

The following is from a group that in this case starts warfarin before a TEE, and uses the TEE to determine whether ot continue using it: http://www.nscardiology.com/ub_f9701.htm

Another: http://www.afibclinic.com/InformationForPatients4.asp

Another group, "Procedures such as TEE, echo, and stress tests do not require any change in Coumadin." http://www.stephenmillermd.com/instCoumadin.htm

Drug InfoNet, in discussing a patient about to undergo a TEE, who is uncomfortable about being on Coumadin, "Answer: Well, it may be the coumadin, however, there are few other alternatives to thinning your blood that would be preferable. Stick with the coumadin until the testing has been done." http://www.druginfonet.com/index.php?pageID=faq/faqstrok.htm

Most of these refer to people on Coumadin for Atrial Fibrillation. I am shocked at the paucity of guiding information available for doctors, or anyone else, for that matter.

I did not see any site where patients were told to go off of warfarin for TEE, but many sites simply did not state either way.

Best wishes,

John & Joann · Nov 24, 2004

Any physician that said to stop Coumadin for 4 days before TEE would be history at our home. The TEE procedure has very minimal risk of bleeding.

4 TEE's here and never changed the Coumadin dosage.

I'd make that Dr. my Thanksgiving Turkey!!!