[AF-FORUM] 151E 心耳内血栓－ Dr. Cezimbra

[AF Symposium]

去年有个患者来找我进行例行咨询。他应用依那普利 
降压。体检时，我发现他有房颤，我问他是否知道自 
己病情，他表示不知道。所以我预约了血凝常规观察 
国际标准化比率（INR），并进行经食管超声心动图检 
查以便进行适当的抗凝治疗，以及接下来将进行的心 
脏复律。他的经食管超声心动图显示在心耳部血栓。 
我调整他的INR值粗略在3.5左右一年时间，并且在6个 
月和12个月仍在应用华法林保持着合适的抗凝作用， 
他的血栓完全没有变化。

该患者是名70岁男子，现在完全不用香豆素类药物 
了。如果他是你的患者你要怎么办呢？

祝好

Alexandre Cezimbra，医学博士，

Rio de Janeiro,巴西



Dr. Sergio Dubner科委会主席Dr. Edgardo Schapachnik
组委会主席



肖明 译 王玲洁 校



151E: Atrial appendage trombus. Dr. Cezimbra

I have a patient who came to me last year for a routine  
consultation.  He was under enalapril as a drug for control of his  
blood pressure.  During the examination I realized that he was on  
atrial fibrilation  and he was then asked by me if he was awared of  
this condition. He  voluntered no. So I ordered APT/ INR and TEE in  
order to begin proper  anticoagulation and following cardiovertion.  
His TEE disclosured an  atrial appendage trombus occluding all its  
area. I kept him during  one year on INR roughly 3,5 and in six  
months and 12 months still on  warfarin and keeping proper  
anticoagulation, his trombus hasn't  changed at all. The patient is a  
70 years old man and is completely  free of sintoms.What would you do  
if this patient were yours.
Sincerely, Alexandre
Cezimbra, MD - Rio de Janeiro, Brazil.

--
Dr. Sergio DubnerPresident of Scientific Committee
Dr. Edgardo Schapachnik President of Steering Committee