AFib - Stroke Prevention

Question 1

Valvular AF

Answer 1

Mechanical Heart Valve or Moderate to Severe Mitral Stenosis
- Anticoagulation is recommended

Question 2

CHADS Score

Answer 2

CHADS score of 1 or greater (2% or greater)
- Anticoagulation is reommended

Question 3

HAS-Bled Score

Answer 3

Score of 3 indicates increased risk of bleeding
- Is not a risk score
- Just gives us an idea on who to be more careful with

Question 4

Stroke Prevention
- Aspirin

Answer 4

Has fallen out of practice now

Question 5

Stroke Prevention
- Warfarin

Answer 5

Pretty good risk reduction

Higher risk of bleeding
- Requires monitoring

Question 6

Stroke Prevention
- DOAC

Answer 6

Equal to or better than Warfarin
- Lower rates of intracranial hemorrhage

Dose adjustments based on
- Age, Weight, Renal Function

Question 7

Stroke Prevention
- DAPT

Answer 7

High risk of bleeding

Question 8

When to use Warfarin

Answer 8

When older/frail patient is stable on Warfarin
- Switching to DOAC can increase risk of bleeds

• Mechanical Valve Replacement
• Moderate to Severe Mitral Stenosis
• Antiphospholipid Syndrome
• Left Ventricular Thrombosis