Background: Aging is associated with increased prevalence of atrial fibrillation and thrombophlebitis. Anticoagulation has been shown to be effective in preventing thromboembolic events in AF patients and treatment of thrombophlebitis. Non-vitamin k antagonist oral anticoagulants (NOACs) have been shown to be non-inferior or even superior to warfarin for long-term stroke prevention and thrombophlebitis treatment. In [...]

Background: Vitamin K antagonists (VKA) remain widely used in the treatment of venous thromboembolism (VTE). During surgical interventions, the prevention of recurrent VTE must be weighed against the increased bleeding risk conferred by anticoagulation. There is a lack of strong evidence to guide the optimal periprocedural management of anticoagulation in patients with prior VTE, and [...]

Background: Warfarin and other anticoagulants increase the risk of hemorrhagic complications, including upper gastrointestinal hemorrhages (UGIB). Warfarin is commonly used in the management of atrial fibrillation to reduce the risk of ischemic stroke, and frequently resumed following UGIB. However, optimal timing of reinitiation remains unclear. Theory suggests that resuming warfarin immediately after UGIB would lead [...]

Background: Warfarin-associated adverse drug events are dangerous, common, and costly. Anticoagulation safety is a national priority. While multiple tools exist for warfarin management in the outpatient setting, there is a dearth of guidance with regard to inpatient management. This study aims to: 1) describe a health system’s inpatient chronic warfarin quality metrics, defined by International [...]

Case Presentation: A 50 year-old African American female with medical history of morbid obesity (BMI 40.8), hypertension, hyperlipidemia, diabetes mellitus, obstructive sleep apnea, atrial fibrillation, right MCA infarct one year prior to admission, and right renal infarct one month prior to admission presented with two days of sharp left-sided abdominal pain associated with non-bloody and [...]

Case Presentation: A 34-year-old Caucasian lady with metabolic syndrome and hypertension presented with a sudden onset 10/10 right lower extremity pain associated with numbness and inability to ambulate. Vital signs were stable. On examination, her right lower extremity was pale, cold and pulseless. Her laboratory tests including hypercoagulable workup were normal. A CT aortogram with [...]

Case Presentation: A 37 year-old female with history of menorrhagia on oral contraceptives (OCP) for 2 months, presented with abrupt onset of right lower quadrant abdominal pain (RLQ) for 1 day. Pain was 10/10, constant, sharp, with radiation to right flank, without alleviating factors. Pain was associated with nausea and multiple episodes of vomiting. She [...]