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The challenge of coprescription of antiplatelet therapy and oral anticoagulants
The coexistence of symptomatic carotid artery stenosis and nonvalvular atrial fibrillation (NVAF) in the recently reported 85year old man [1] bears out the findings of the study which documented a 24.3% prevalence of high-grade (50% or more) carotid artery stenosis among 103 consecutive NVAF patients (mean age 69) who presented with stroke [2]. Among these patients with high-grade stenosis 66.7% had stenosis ipsilateral to the cerebral infarct [2]. Given the fact that patients with symptomatic carotid artery stenosis are at high risk of stroke recurrence and/or worsening neurological disability during the first 14days foll...
Source: The American Journal of Emergency Medicine - May 22, 2017 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Acute aortic occlusion in a patient without risk factors
A 94-year-old female with a history of ischemic stroke, mild right hemiparesis, vascular dementia, breast cancer with right mastectomy, colon cancer resulting in colectomy, hyperlipidemia, and hypertension presented to the emergency department (ED) with bilateral leg pain. Patient had no smoking history, and her medications included Donepezil, Aspirin, Citalopram, Losartan, and Pantoprazole.
Source: The American Journal of Emergency Medicine - March 28, 2018 Category: Emergency Medicine Authors: Trina Stoneham, Erin L. Simon Source Type: research