Your scary medical video of the day (not graphic)
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@mark that’s why people with atrial fibrillation take Coumadin. A fibrillating atrium is the reason thrombi form in the heart. The idea is the anti coagulant will suppress thrombus formation. The way it’s fixed is the bodies own system for breaking down thrombi, called fibrinolysys.
Isn’t medicine kewl?
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Are such clots always a problem, or are there harmless outcomes, too? If so, is there any data on the probability that it will result in something harmful?
I guess that particular clot is not necessarily the only problem but more that the body as such has a higher likelihood of producing clots.
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@klaus said in Your scary medical video of the day (not graphic):
Are such clots always a problem, or are there harmless outcomes, too? I
As long as it stays where it is, it's probably harmless. This sucker looks so big that it might not even get across the mitral valve into the LV. The danger is when it does cross, it will go into the systemic circulation. Imagine an artery clogged by something that big.
Also, these thrombi can break apart, sending a shower of clots througough the circulation. This is a very bad thing.
Note how irregularly that heart is beating - the EKG shows atrial fib as well. If i had to guess (and I'm no echocardiography), this is a case of mitral stenosis causing left atrial enlargement (it should NOT be that big) and atrial fibrillation. It could be that the mitral stenosis is what's keeping the clot in the LA. But, as I said, there's nothing preventing it from breaking up and sending clot everywhere.
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"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@mark that’s why people with atrial fibrillation take Coumadin. A fibrillating atrium is the reason thrombi form in the heart. The idea is the anti coagulant will suppress thrombus formation. The way it’s fixed is the bodies own system for breaking down thrombi, called fibrinolysys.
Isn’t medicine kewl?
@bachophile said in Your scary medical video of the day (not graphic):
@mark that’s why people with atrial fibrillation take Coumadin. A fibrillating atrium is the reason thrombi form in the heart. The idea is the anti coagulant will suppress thrombus formation. The way it’s fixed is the bodies own system for breaking down thrombi, called fibrinolysys.
Isn’t medicine kewl?
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
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@bachophile said in Your scary medical video of the day (not graphic):
@mark that’s why people with atrial fibrillation take Coumadin. A fibrillating atrium is the reason thrombi form in the heart. The idea is the anti coagulant will suppress thrombus formation. The way it’s fixed is the bodies own system for breaking down thrombi, called fibrinolysys.
Isn’t medicine kewl?
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@george-k said in Your scary medical video of the day (not graphic):
There is a Grey's Anatomy episode on a mistake like that. In that episode, the fictitious patient died.
https://en.wikipedia.org/wiki/Jeff_Chandler
While working on Merrill's Marauders in the Philippines, on April 15, 1961, Chandler injured his back while playing baseball with U.S. Army Special Forces soldiers who served as extras in the film. He had injections to deaden the pain and enable him to finish the production.
On May 13, 1961, he entered a hospital in Culver City, California, and had surgery for a spinal disc herniation. Severe complications arose; an artery was damaged, and Chandler hemorrhaged. On May 17, in a seven-and-a-half-hour emergency operation following the original surgery, he was given 55 pints of blood. A third operation followed, on May 27, where he received an additional 20 pints of blood. He died on June 17, 1961. The cause was a blood infection complicated by pneumonia.
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@george-k omg
@bachophile I saw something similar in the early 1980s. An orthopedic surgeon, while doing a laminectomy, or a fusion, happened to bag the aorta with a rongeur. I have no idea what he was doing so far anteriorly, but the bleeding was fast and spectacular.
Fortunately, it was during the daytime, and there was a vascular surgeon around who could repair the damage.
No, I don’t remember the details, and it wasn’t my case, thank goodness!
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@89th said in Your scary medical video of the day (not graphic):
Some days I prefer not to think about how incredible (and fragile) the human body is.
Burning Rope
The warming sun, the cooling rain
The snowflake drifting on the breath of the breeze
The lightning bolt that frees the sky for you
Yet only eagles seem to pass on through
The words of love, the cries of hate
And the man in the moon who seduced you
Then finally loosed youYou climbed upon a burning rope to escape the mob below
But you had put the flaming out so that others could not follow
To be out of the bounds and the barks of those who do not wish you well
You must blaze a trail of your own, unknown, aloneBut keep in mind
Don't live to-day for tomorrow like you were immortalThe only survivors on this world of ours are
The warming sun, the cooling rain
The snowflake drifting on the breath of the breeze
The lightning bolt that frees the sky for you
Yet only eagles seem to pass on through
The words of love, the cries of hate
And the man in the moon who seduced you
Then finally loosed youYou're old and disillusioned now as you realise at last
That all you have accomplished here will have soon all turned to dust
You dream of a future after life, well that's as maybe, I don't know
But you can't take what you left behind, you're all aloneSo keep in mind
Don't live to-day for tomorrow like you were immortalThe only survivors on this world of ours are
The warming sun, the cooling rain
The snowflake drifting on the breath of the breeze
The lightning bolt that frees the sky for you
Yet only eagles seem to pass on through
The words of love, the cries of hate
And the man in the moon... -
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
@george-k said in Your scary medical video of the day (not graphic):
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
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@george-k said in Your scary medical video of the day (not graphic):
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
@brenda said in Your scary medical video of the day (not graphic):
@george-k said in Your scary medical video of the day (not graphic):
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
BTW, Hubby participated in a genetic study for Mayo, and learned his body will not metabolize Plavix, so they put him on the Eliquis.
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@george-k said in Your scary medical video of the day (not graphic):
@jolly said in Your scary medical video of the day (not graphic):
@bachophile said in Your scary medical video of the day (not graphic):
Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?
Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..
Terrible terrible drug.
The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.
Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
@brenda said in Your scary medical video of the day (not graphic):
Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.
And Eliquis?
Same thing.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904756/
Planning for elective surgery or invasive procedures should involve balancing the intervention-associated bleeding risk and thrombotic risk associated with anticoagulant interruption in each individual. A “safe” residual drug level of apixaban for surgery is presently unknown, and no test has been correlated with bleeding risk. As such, there is currently no known threshold at which apixaban patients’ bleeding risk are able to be comparable to non-apixaban treated patients [27].
In general, apixaban should be discontinued 2 to 3 days prior to elective surgery or invasive procedures [5], as outlined below and in Figure 2.
