Anticoagulation in cardiac diseases. Prevention and control of thromboembolic events.

Thrombosis is a common feature of cardiac diseases. In valvular heart disease, anticoagulant therapy is recommended to prevent an initial embolic episode in high-risk patients or recurrent episodes in patients who have had an embolic event. Prophylaxis is recommended for patients over age 40. For patients with prosthetic heart valves, chronic anticoagulant therapy is recommended immediately after surgery, followed by long-term use of oral anticoagulants. Moderate doses of subcutaneous or intravenous heparin should be given for at least two weeks in patients with acute transmural infarction, unstable angina, or sudden cardiac arrest. In addition, anticoagulation is currently recommended for use in patients with chronic cardiomyopathy associated with congestive heart failure or atrial fibrillation.