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Re: PMB on coumadinFrom: DoctorJoe@aol.comFri Apr 27 10:51:07 2007
In a message dated 4/27/2007 10:47:09 A.M. Central Daylight Time, henrygregor@yahoo.com writes: A 53 yo, LMP 4 years ago, presents with two weeks plus heavy vaginal bleeding, w/o presyncopal sx's. She is on coumadin secondary to hx of mitral valve replacement. INR is 2.3, and pt is w/o petechiae, ecchymoses, or hx of epistaxis or bleeding gums, etc. PE is unremarkable, and a pap (neg hx abnl past ones) is pending. Sono with heterogenous endometrial stripe, at 7 mm. I am planning to do an endometrial pipelle sampling. Comments appreciated. Thanks Hank Just as a tangential thought: If she's got an appropriate mechanical valve, some of them have data to support the NON-use of Coumadin nowadays. She may not fit the criteria, but you can get her to ask the cardiologist if she could be switched to Aspirin/Plavix or whatever as appropriate "anticoagulation." As I say, it may not be right for her, but if she fits, it'd be a lot easier and safer than being on Coumadin forever. Joe P.
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