Warfarin
- Thread starter ronk
- Start date
Good old rat poison as a medicine.
I'm no doctor but my father had a massive heart attack and was told that the long term use of Warfarin was a major contributor.
Having subsequently read the side effects I'd certainly want to be sure that the benefits outweighed them...
I'm no doctor but my father had a massive heart attack and was told that the long term use of Warfarin was a major contributor.
Having subsequently read the side effects I'd certainly want to be sure that the benefits outweighed them...
Who recommended warfarin? Was it your GP or a cardiologist? If you haven't seen the latter, I would ask your GP to refer you for a second opinion.
If the AF is of recent onset, I would explore the reasons why you've developed the condition and see if it can't be rectified. If there's potential for it to be successful, cardioversion must be a better option than a life time of anticoagulation.
CJ, I can't see a causative link between warfarin use and a heart attack, but the condition that necessitated warfarinisation might have been the precipitant.
Certainly, there is a link between warfarin use and haemorrhagic stroke, often after fairly insignificant head trauma for obvious reasons. In the elderly, bridging veins between the brain and dura are under relative tension as the brain undergoes atrophy and literally shrinks away from the skull. These veins can be torn easily and lead to a chronic subdural haematoma; in the warfarinised patient, this may be a devastating acute bleed.
Warfarin is always a hassle, even if your levels are usually well controlled. Every new drug you're given can influence its metabolism make your blood too thin or not thin enough. That Christmas glass or two of wine that's more than your usual can have an effect, not to mention making accidents more likely with an associated risk of haemorrhage. If you need an operation, it may be delayed whilst your INR stabilises. Any trivial bleed - an ulcer, a haemorrhoid, a laceration - will be unnecessarily complicated by warfarin. The list of potential problems is endless...
The reason why you've been prescribed warfarin is to reduce your risk if embolic stroke. If your atria are beating irregularly and too rapidly, they will not empty of blood with each cardiac cycle. As such, there is a risk of stasis leading to thrombosis within the atria. If a piece of this clot from your left atrium detatches, it may travel in the vessels to your brain causing vascular occlusion and thence a stroke. There are many factors that govern your risk of forming such mural thromboses, just as there are many causes for atrial fibrillation - some reversible, some not. I strongly recommend you discuss this with a cardiologist who will be able to stratify your own particular risk and then advise you regarding your own need for warfarin and your potential suitablility for cardioversion. If their verdict is to use warfarin, then I'm afraid you're stuck with it! Good luck.
If the AF is of recent onset, I would explore the reasons why you've developed the condition and see if it can't be rectified. If there's potential for it to be successful, cardioversion must be a better option than a life time of anticoagulation.
CJ, I can't see a causative link between warfarin use and a heart attack, but the condition that necessitated warfarinisation might have been the precipitant.
Certainly, there is a link between warfarin use and haemorrhagic stroke, often after fairly insignificant head trauma for obvious reasons. In the elderly, bridging veins between the brain and dura are under relative tension as the brain undergoes atrophy and literally shrinks away from the skull. These veins can be torn easily and lead to a chronic subdural haematoma; in the warfarinised patient, this may be a devastating acute bleed.
Warfarin is always a hassle, even if your levels are usually well controlled. Every new drug you're given can influence its metabolism make your blood too thin or not thin enough. That Christmas glass or two of wine that's more than your usual can have an effect, not to mention making accidents more likely with an associated risk of haemorrhage. If you need an operation, it may be delayed whilst your INR stabilises. Any trivial bleed - an ulcer, a haemorrhoid, a laceration - will be unnecessarily complicated by warfarin. The list of potential problems is endless...
The reason why you've been prescribed warfarin is to reduce your risk if embolic stroke. If your atria are beating irregularly and too rapidly, they will not empty of blood with each cardiac cycle. As such, there is a risk of stasis leading to thrombosis within the atria. If a piece of this clot from your left atrium detatches, it may travel in the vessels to your brain causing vascular occlusion and thence a stroke. There are many factors that govern your risk of forming such mural thromboses, just as there are many causes for atrial fibrillation - some reversible, some not. I strongly recommend you discuss this with a cardiologist who will be able to stratify your own particular risk and then advise you regarding your own need for warfarin and your potential suitablility for cardioversion. If their verdict is to use warfarin, then I'm afraid you're stuck with it! Good luck.
I have been on it for over 10 years with no problems. I had a blood clot in my leg. I still do long haul flights .Go skiing. Just wear flight socks. Move around the cabin now and again to keep the legs moving. It means I am not likely to have a stroke because I take it. 
Your detailed reply is very much appreciated. Thank you.
I was supposed to start the rat poison today as advised by the warfarin clinic last Friday - I was given a cancelled appointment and wasn't able to do any homework prior to the consultation and I have fealt that I've been bounced into taking the drug by a biased opinion of the clinic.
I'm going to have a chat with my GP tomorrow prior to taking the medication . Whichever that medication may be!
I was supposed to start the rat poison today as advised by the warfarin clinic last Friday - I was given a cancelled appointment and wasn't able to do any homework prior to the consultation and I have fealt that I've been bounced into taking the drug by a biased opinion of the clinic.
I'm going to have a chat with my GP tomorrow prior to taking the medication . Whichever that medication may be!
Nelly Welly
Active member
If it's any support my mother was prescribed warfarin and it maintained her life for more than thirty years after developing deal veined thrombosis i. The early seventies.
May not be the modern drug of choice but it kept her alive longer than would normally have been expected.
May not be the modern drug of choice but it kept her alive longer than would normally have been expected.
Recurrent deep vein thrombosis +/- pulmonary embolism is an entirely different indication for prescribing warfarin. For those who have proven themselves to have a propensity for intravascular coagulation, then warfarin may save them from a fatal pulmonary embolism. There is far less debate about the risk : benefit ratio in such circumstances.
The use of warfarin in uncomplicated AF is open to debate. This is especially so in an otherwise well, highly active, young individual who is at not inconsiderable risk of complications when exposed to its use for decades.
I'm neither a cardiologist nor a stroke physician - either will be able to give you a less biased opinion than both your GP or I can.
The use of warfarin in uncomplicated AF is open to debate. This is especially so in an otherwise well, highly active, young individual who is at not inconsiderable risk of complications when exposed to its use for decades.
I'm neither a cardiologist nor a stroke physician - either will be able to give you a less biased opinion than both your GP or I can.
:lol: Ronk, as a GP I often deal with patients with AF and warfarin. I could go on about it but its not the most appropriate to offer guidance to a person who's history I don't know and on this medium. All I would advise is that you urgently discuss the matter with your GP and seems you are on to it tomorrow . Hope he/she can give you the appropriate guidance in a way you understand thoroughly (lots of technical terminology in BMWZ4MCs posts above which might have been hard to follow).
Oh and BMWZ4MC, GPs can initiate anticoagulation based on a case by case assessment taking into account CHADS2VASC and HASBLED scores. Doesn't always have to be the cardiologist or stroke physician.
. Hope he/she can give you the appropriate guidance in a way you understand thoroughly (lots of technical terminology in BMWZ4MCs posts above which might have been hard to follow). Oh and BMWZ4MC, GPs can initiate anticoagulation based on a case by case assessment taking into account CHADS2VASC and HASBLED scores. Doesn't always have to be the cardiologist or stroke physician.
Thanks Ruby. Im going to go into see my GP tomorrow and have a sit down chat. My medication for my AF seems be working and they seem to be looking at an anti coagulation regime - Warfarin seems rather old hat now and also has a rather restricting diet - especially when combined with a diabetic diet!
Its certainly spoiled my weekend
I had the chat with my GP this morning and she explained the situation very well and put my mind at some rest - I am to start my warfarin and maybe switch to one of the recent drugs when a "switch off " is developed.
In her opinion. it was better to stay with the treatment that could be turned off should any need arise. However should I not be able to maintain my target 2.5 or not tolerate the drug she would prescribe an alternative.
Cant say Im keen but its better than the risks of not taking the medication.
Oh what a nice Christmas gift
In her opinion. it was better to stay with the treatment that could be turned off should any need arise. However should I not be able to maintain my target 2.5 or not tolerate the drug she would prescribe an alternative.
Cant say Im keen but its better than the risks of not taking the medication.
Oh what a nice Christmas gift