Fatal acute haemopericardium associated with rivaroxaban in a patient with non-valvular atrial fibrillation

AbstractAn 82-year-old female was admitted with chest pain and non-specific T wave changes on her ECG. After 72 hours of conservative management she deteriorated with non-specific symptoms including nausea and a single episode of vomiting. Abdominal and Chest X-rays were unremarkable, blood tests showed worsening Acute Kidney Injury (AKI) on Chronic Kidney Disease (CKD); and raised C-Reactive Protein (CRP) with no obvious symptoms or focus of infection. She rapidly deteriorated going into asystole cardiac arrest and attempts at resuscitation failed.Post-mortem examination suggested the most likely cause of death was acute spontaneous Haemopericardium due to Rivaroxaban therapy which she was on for non-valvular Atrial Fibrillation (AF).We believe that this might be the first reported mortality with Rivaroxaban-associated spontaneous haemopericardium in the UK.
Source: Age and Ageing - Category: Geriatrics Source Type: research

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Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Siriluck Ponsuksili1, Nares Trakooljul1, Frieder Hadlich1, Karen Methling2, Michael Lalk2, Eduard Murani1 and Klaus Wimmers1,3* 1Leibniz Institute for Farm Animal Biology (FBN), Institute for Genome Biology, Functional Genome Analysis Research Unit, Dummerstorf, Germany 2Institute for Biochemistry – Metabolomics, University of Greifswald, Greifswald, Germany 3Faculty of Agricultural and Environmental Sciences, University of Rostock, Rostock, Germany Given the central metabolic role of the liver, hepatic metabolites and transcripts reflect the organismal physiological state. Biochemical-clinical plasma bio...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Introduction:The presence of pulmonary hypertension (PH) in myeloproliferative disorders (MPD) has been evaluated in several small studies with mainly echocardiographic assessment of the right ventricular systolic pressures (RVSP). Left-sided heart disease is the most common cause of PH, and the incidence of diastolic dysfunction increases with age. Since MPD is more prevalent in older patients, it is unknown how much of PH is related to diastolic dysfunction. In addition, the presence and effect of concomitant cardiovascular diseases on overall mortality in these patients is unknown. To assess above knowledge gaps, we eva...
Source: Blood - Category: Hematology Authors: Tags: 634. Myeloproliferative Syndromes: Clinical: Poster III Source Type: research
A late middle-aged man presented with one hour of chest pain.  He had significant history of CAD with CABG x5, and repeat CABG x 2 as well as a subsequent PCI of the graft to the RCA (twice) and of the graft to the Diagonal.   Most recent echo showed EF of 60%.  He also had a history of chronic kidney disease, stage III.He had recently had a NonSTEMI. Angio had shown some acute disease in the saphenous vein graft to the posterior descending artery off of the RCA.  He was managed medically with Clopidogrel.  Medics stated that he had not been taking his clopidogrel for 2 weeks.He appeared to be in s...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and th...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research
Publication date: Available online 24 March 2016 Source:Advances in Digestive Medicine Author(s): Chang-Hua Chen, Kun-Ching Chou, Lien-Cheng Tsao Tuberculous peritonitis (TBP) is a continuing problem in populations with high prevalence of tuberculosis and is difficult to diagnose early. Here, we report a case of confirmed TBP that presented as intestinal ileus and pneumatosis intestinalis. The 79-year-old woman had a history of atrial fibrillation, chronic ischemic heart disease, and chronic renal failure (chronic kidney disease, stage V). She complained of abdominal fullness and pain for 1 week prior to hospitalizati...
Source: Advances in Digestive Medicine - Category: Gastroenterology Source Type: research
CONCLUSION: Risk factors associated with the development of chronic kidney disease following renal infarction are unknown. In our subjects, renal function remained stable in all but one patient who developed end stage renal disease. Further studies should focus on etiology and evolution of kidney function in patients with acute renal infarction. PMID: 26743079 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
The results of the SPRINT trial are in, and you’ve probably heard that making 120 mm Hg the new blood pressure target helped lower mortality rates. Yet the study outcomes apply only to a specific subset of patients with hypertension. See whether or not your patients may fit into this category. In the much-anticipated results of the SPRINT trial, the relative risk of death from cardiovascular causes was 43 percent lower for patients receiving more intensive treatment for a 120 mm Hg target versus those who received standard treatment for a 140 mm Hg target. While these results were unexpected and are noteworthy...
Source: AMA Wire - Category: Journals (General) Authors: Source Type: news
r J Abstract The direct oral anticoagulants (DOAC) dabigatran, rivaroxaban, and apixaban are increasingly prescribed in atrial fibrillation (AF) patients, although dosage in elderly patients, safety in chronic kidney disease, food- and drug-interactions, laboratory tests for monitoring, and antidote are not clarified. In a 78-year-old man with an acute stroke, paroxysmal AF and sick-sinus-syndrome were detected as he received a DDD-pacemaker and 5 mg apixaban/bid. He had a history of hypertension, hypothyroidism, diabetes mellitus, hyperlipidemia, sleep apnea, lumbar discopathy, and nephropathy. Renal function det...
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
Abstract BackgroundConcern about the renal safety of commonly used cardiovascular drugs with demonstrated clinical benefit appears to be an obstacle to their use in the elderly. ObjectivesTo describe the relationship between cardiovascular drugs and chronic kidney disease (CKD) in elderly individuals in the real‐life setting. Designancillary study of the prospective non‐interventional S.AGE (aged individuals) cohort. SettingGeneral physicians were free to prescribe any drug their patients needed. Participantsnon‐institutionalized patients aged 65 years and older treated by their primary physician for either chronic p...
Source: Basic and Clinical Pharmacology and Toxicology - Category: Drugs & Pharmacology Authors: Tags: Original Article Source Type: research
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