Patient Suffers Heart Attack, Stroke After Doctor Stops Coumadin

Case Overview

This case involves a male patient who underwent orthopedic surgery for a spine condition. He was re-admitted due to wound dehiscence and underwent an additional surgery to repair the wound. The patient had a past medical history of atrial fibrillation and was on Coumadin. He was left without Coumadin in the post-surgical phase. He ultimately went on to suffer an occlusion of his coronary artery, which caused a significant myocardial infarction with septal defect all requiring open heart surgery, as well as an ischemic stroke.

Questions to the Pediatrics expert and their responses

Do you routinely treat patients like the one described in this case?

I have and continue to routinely treat and have treated multiple patients such as the individual in this case. My experiences have included working in the cardiac catheterization lab for 25 years, attending on the inpatient cardiology services, extensive experience in the outpatient clinics, and providing consultations. In addition, I have been the director of the coronary care unit and Vice-Chair of clinical medicine in the Department of Internal Medicine. I was the director of cardiovascular training for over 25 years and have been actively involved in teaching medical students, interns, residents, and cardiovascular fellows.

Have you ever had a patient develop the outcome described in this case?

I personally have not experienced an outcome in any of my patients but have reviewed similar cases treated by other physicians. I do believe that the patient would have had a better outcome had appropriate care been rendered. I was also involved in clinical research during my initial 10 or 15 years on the faculty.

About the expert

This board certified expert in cardiology is fellowship trained and has been practicing for almost 40 years. In addition to over 100 publications and over 150 speaking engagements, he has received numerous grants and fellowships for his cardiology research. A member of both the American College of Cardiology and the American Heart Association, the expert has been a member of numerous committees for a major university medical center where he currently serves as Medical Director for one of the university heart centers.

E-007419

Specialties:

Pediatrics