Raised international normalized ratio: an early warning for a late cardiac tamponade?

Ann Thorac Surg. 2006 Sep;82(3):1090-1. doi: 10.1016/j.athoracsur.2006.01.035.

Abstract

Seven consecutive cases of late cardiac tamponade after valvular surgery are reported; all were postoperatively treated with acenocoumarol and 6 had an international normalized ratio peak greater than 6.0 within 3 days preceding tamponade. It is suggested that during this excessive anticoagulation state a hemorrhagic event within the pericardial space precipitates the tamponade. In addition, it is proposed that all valve patients with a postoperative international normalized ratio peak greater than 5.0 within 6 weeks postoperatively should be considered for a transthoracic echocardiogram.

Publication types

  • Case Reports

MeSH terms

  • Acenocoumarol / administration & dosage
  • Acenocoumarol / adverse effects*
  • Adult
  • Aged
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Cardiac Tamponade / blood
  • Cardiac Tamponade / diagnosis*
  • Cardiac Tamponade / diagnostic imaging
  • Drainage
  • Female
  • Heart Valve Prosthesis Implantation
  • Humans
  • International Normalized Ratio*
  • Male
  • Middle Aged
  • Pericardial Effusion / etiology*
  • Pericardial Effusion / surgery
  • Postoperative Complications / blood
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / diagnostic imaging
  • Retrospective Studies
  • Time Factors
  • Ultrasonography

Substances

  • Anticoagulants
  • Acenocoumarol