TIA & Warfarin

[Cris N]

Here's a question that came up at work today... if you experience a TIA while on warfarin is it a sign that INR is too low?

 

[Guest]

A TIA is a stroke that lasts less than an hour. It is a huge risk factor for having a major stroke. It can be caused by a low INR. It is nothing to be simply blown-off. It needs an immediate work-up. This would include an INR. Many times TIAs are blown-off by the ER staff because they like more interesting things to take care of. If your INR is low, at least you can correct this. If you have a TIA and your INR is in the therapeutic range, it can mean impending disaster. There needs to be a workup to find why the TIA occurred. It can be a sign of a faulty valve, infection in the sewing cuff of the valve and a number of other things. One thing that is not likely to be present in a valve patient (but is a person whose heart has not been widely examined) is a hole in the heart that a allows blood to cross from the right to the left side. It was once thought that this was not common in adults but with better diagnostic techniques it is being found more often.

However you look at it, a TIA is a serious medical condition.

 

[Mb]

Hello:

My husband is on coumaden. He had a very small stroke (confirmed by an MRI in Feb.), and then a TIA if February. His INR was 1.8 at the time of the second incident. We do not know when the first ocurred, except to say that he started experiencing leg weakness mid-January. He goes to clinic like clockwork. Does NOT miss an appt., and all of the appointments were within range, except the one in February. We have been told by many peopel that you cannot have a stroke while on coumaden, as long as the INR is within range. And yet, I know he did. And, another patient at his clinic just had a stroke, and was within range as well. Doesn't give one a lot of confidence, and yet he would not be alive today if it weren;t for the drug. Yeah! Coumaden!! BTW, no one did any further tests, including a simple EKG, when they discovered the brain infarct. But, frankly, what can they do anyway. (He has dual valves, chronic a-fib, and a severely leaking tricuspid valve.) - Marybeth

 

[Guest]

The person who believes that you cannot have a stroke while on warfarin probably also believes that you cannot have an accident if you are driving under the speed limit. In both cases, you cut, but not eliminate, the risk.

 

[RCB]

Stokes, TIA and people

Stokes, TIA and people

"We have been told by many peopel that you cannot have a stroke while on coumaden, as long as the INR is within range. And yet, I know he did. And, another patient at his clinic just had a stroke, and was within range as well. Doesn't give one a lot of confidence, and yet he would not be alive today if it weren;t for the drug. Yeah! Coumaden!!"

People who have tissue valves have strokes and TIAs!
People who have their natural valves and no heart problems have strokes and TIAs!
People who have hip replacement and on warfarin have strokes and TIAs!
People who know nothing about warfarin are always givening bad advice!
People who are smart, seek the advice of expert people like MR. Lodwick!
We are so lucky to have him.

 

[Mb]

Yes, I'll ditto that! Reading much of the advise over the years from Al has given me and my husband much more knowledge, and confidence in this drug. Actually, it was from Al's advice originally, that my husband finally got his INR regulated after his surgery. It wasn't from the clinic he goes to, it was from Al. So, yes, Al, we are SO happy to have you here. Thank you for all of the advise over the years.

Marybeth

 

[Nancy]

Joe's had about 16 TIAs, in good INR range and out of range. He hasn't had one in a long time. They happened during a period of time when his mitral was symptomatic, and also when his pulmonary hypertension was severe.

I am always on the lookout for symptoms of one with him.

And, yes, Al is the best thing since sliced bread

 

[Guest]

Thanks, Mom & Sis

 

[Cris N]

Thanks for all info... the responses were pretty much what I expected.