D M Blunt1, M G Impallomeni. 1. Department of Imaging, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. dblunt@hhnt.nhs.uk
Abstract
BACKGROUND: The risk/benefit ratio of warfarin therapy changes in the over 75s, when haemorrhagic side-effects become more common. These may not always be reported in the literature. CASE REPORT: A woman of 80 years, on long-term warfarin therapy presented with an acute dissecting thoracic aortic aneurysm; on investigation the only precipitating factor found was an international normalised ratio of 4.8. This patient, who also had an abdominal aortic aneurysm, survived, on discontinuation of her anticoagulant therapy. CONCLUSIONS: We describe a previously unreported complication of warfarin therapy in a patient over 75 years of age, to add to the cautions in prescribing this drug in patients of this age group.
BACKGROUND: The risk/benefit ratio of warfarin therapy changes in the over 75s, when haemorrhagic side-effects become more common. These may not always be reported in the literature. CASE REPORT: A woman of 80 years, on long-term warfarin therapy presented with an acute dissecting thoracic aortic aneurysm; on investigation the only precipitating factor found was an international normalised ratio of 4.8. This patient, who also had an abdominal aortic aneurysm, survived, on discontinuation of her anticoagulant therapy. CONCLUSIONS: We describe a previously unreported complication of warfarin therapy in a patient over 75 years of age, to add to the cautions in prescribing this drug in patients of this age group.