Pharmaceutical care on a patient with atrial fibrillation after rheumatic mitral valve replacement
SHAO Dan
YIN Hang
YAN Xiao-qing
Abstract：One 78-year-old female patient was hospitalized because of paroxysmal palpitations, wheezing for more than 40 years and aggravation for half a month. The clinical diagnosis were rheumatic heart disease, postoperative mitral valve replacement; heart failure, cardiac function grade Ⅳ; arrhythmia, atrial fibrillation, premature ventricular contraction; high blood pressure, level 3, very high risk. The patient had more than 40 years history of rheumatic heart disease. The patient experienced mitral valve replacement 15 years ago and had been regularly taken warfarin sodium tablets up to now. After admission, the result of the coagulation function indicated that the patient was in high risk of bleeding with an international normalized ratio (INR) 6.07, which was much higher than normal INR (2.0 – 3.0). Therefore, clinical pharmacist suggested stopping warfarin sodium tablets and analyzed the reasons resulted in the high INR. After resetting the dosage of warfarin sodium and changing irbesartan tablets to telmisartan tablets, the patient was improved and discharged 9 days later.
Keywords：Rheumatic mitral valve replacementAtrial fibrillationAnticoagulant therapyWarfarinPharmaceutical care
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 148-150 )