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VOLUME 5 , ISSUE 2 ( July-December, 2020 ) > List of Articles

CASE REPORT

Anesthesia Management of a Case of Subdural Hematoma in a Patient of Severe Mitral Stenosis with Warfarin Toxicity: A Case Report

Pallavi A Kharat, Sudhams Tarapatala

Citation Information : Kharat PA, Tarapatala S. Anesthesia Management of a Case of Subdural Hematoma in a Patient of Severe Mitral Stenosis with Warfarin Toxicity: A Case Report. Res Inno Anesth 2020; 5 (2):49-51.

DOI: 10.5005/jp-journals-10049-0089

License: CC BY-NC 4.0

Published Online: 01-04-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Valvular heart diseases have a mixed presentation in healthcare settings all over the world. Rheumatic heart disease still forms the major cause of these valvular lesions. Mitral and aortic valvular diseases top the list of valvular pathology.1 Thereby, a thorough understanding of the pathophysiology of valvular heart disease is essential in planning anesthesia and perioperative care of such patients. Judicious use of fluids, close monitoring of the changing hemodynamics, and avoiding major reduction of cardiac output and fluid shifts are mandatory to achieve a good clinical outcome. These patients are at risk of the thromboembolic episode for which they are on long-term anticoagulation.2 So timely monitoring of the coagulation profile is needed. The risk of bleeding increases if international normalized ratio (INR) >4.5.3 We hereby present a case of subdural hematoma in a case of severe mitral stenosis with warfarin toxicity posted for burr hole surgery.

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  1. Paul A, Das S. Valvular heart disease and anaesthesia. Indian J Anaesth 2017;61(9):721. DOI: 10.4103/ija.IJA_378_17.
  2. Chaitanya P, Nikhar S, Prasad CRK, et al. Emergent management of a case with acute sub-dural hematoma post mechanical mitral valve replacement on warfarin therapy. Anaesthesia, Pain Intens Care 2019. 102–104.
  3. Stein PD, Grandison D, Hua TA, et al. Therapeutic levels of oral anticoagulation with warfarin in patients with mechanical prosthetic heart valves. Review of literature recommendations based on international normalized ratio. Postgrad Med Journal 1994;70(1):S72–S85.
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  7. Choudhary GVS, Narayan TJ, Basha SA, et al. Anticoagulant-related subdural hematoma in patients with mechanical heart valves. Neurology Asia 2005;10:13–19.
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