Laila is a 7 year old female known case of congenital mitral valve stenosis who underwent valve replacement at age of 3 months and she is maintained on warfarin with monthly follow-up of her coagulation status. Her last INR was 5 three weeks ago so her dose of Warfarin was decreased by 15%. She presented to ER with 2 days history of vomiting, frontal headache and somnolence. CT brain without contrast is shown below:
What's the most appropriate level of INR she could have now?
- 0.5
- 2
- 3.5
- 7
What's your most appropriate next step of management?
- Switch from Warfarin to Heparin
- Start vitamin K and fresh freozen plasma transfusion
- Transfuse with platelets
- Observation
Start vitamin K and fresh freozen plasma transfusion
ReplyDeleteThis is true. The patient INR was 7 which is too high. The typical INR for such patient is 2.5-3.5
ReplyDeleteThanks!