Conditions Requiring Anticoagulant Therapy
There are many conditions that require this treatment, some of the most common are:
Atrial Fibrillation/stroke prevention
What is Atrial Fibrillation?
Normally, your heart contracts and relaxes to a regular beat. The heart has cells that produce electric signals and these cause the heart to contract and pump blood. In atrial fibrillation (AF), the heart’s two small upper chambers (atria) don’t beat the way they should. Instead of beating in a normal pattern, the atria may beat irregularly and in many cases too fast.
Complications of Atrial Fibrillation
Clots and stroke
One of the most common complications with atrial fibrillation is the formation of blood clots in the heart chambers. The blood in the atria of a patient with atrial fibrillation does not flow out in a normal manner and can be turbulent. There is a greater likelihood of blood pooling and not flowing at a normal rate. When this occurs there is a risk of blood stasis (slowing down) and clots forming. The clots may then find their way into the lower chambers of the heart (ventricles) and eventually end up in the lungs (pulmonary embolism) or in the general circulation. Clots in the general circulation may eventually block arteries in the brain, causing a stroke.
A person with atrial fibrillation is twice as likely to develop a stroke compared to other people. 5% of people with atrial fibrillation get a stroke each year. The risk is even greater the older the person is.
Deep vein thrombosis
What is Deep Vein Thrombosis?
Deep vein thrombosis (DVT) is where a blood clot (thrombus) forms in one or more of the deep veins in your body, most commonly in your legs. Deep vein thrombosis can cause pain and swelling, but can occur without any symptoms. However, possible symptoms can include:
- pain, swelling and tenderness in one of your legs (usually your calf)
- a heavy ache in the affected area
- warm skin in the area of the clot
- redness of your skin, particularly at the back of your leg, below the knee
What is a pulmonary embolism?
Pulmonary embolism is where a blood clot blocks/occludes the pulmonary artery (the blood vessel that transports blood from the heart to the lungs). This can be a serious and potentially life-threatening condition as it can prevent blood from reaching your lungs. The signs and symptoms of a pulmonary embolism can vary between different people, however the symptoms can include:
- Chest pain , this can be – a sharp, stabbing pain that may be worse when you breathe in
- Shortness of breath, this can – come on suddenly or have developed gradually
- Coughing this is - usually dry and may include coughing up blood or mucus that contains blood
- Feeling faint or dizzy
- Passing out
Artificial heart valves
Artificial heart valves are devices that are implanted (open heart surgery) into the hearts of people who suffer from diseased heart valves. When one of the four heart valves malfunctions, the medical choice may be to replace the natural valve with an artificial valve. Artificial heart valves are designed to replicate the function of the natural valves of the human heart.
There are two types of artificial heart valves - mechanical/prosthetic and tissue/biological valves.
Mechanical/prosthetic heart valves can last indefinitely but they require lifelong treatment with an anticoagulant.
Tissue/biological heart valves are made of tissue, traditionally from pig heart valves. These do not require the lifelong use of anticoagulants. The disadvantage of these valves is that they last only about 15 years before they need replacing.
NPSA – Oral Anticoagulant Therapy – Information booklet for patients and carers
Newham community services, also supports the delivery of a patient self-testing and self-management programmes.
This programme supports patients who wish to take a greater role in the management of their own health, especially those who:
• Have work commitments
• Travel regularly
- Patients provide blood test reading
- Contacts the health professional
- The health professional makes dosing decisions
- Patients provide and adjust their own warfarin readings
- Usually within a specific guideline
Links to supporting websites