The War Against Warfarin: Evaluating Current Treatment Guidelines for Patients Who Have Had an Acute Ischemic Stroke and Are Taking Warfarin

摘要

A 52-year-old white woman was brought to the emergency department because of altered mental status. When she entered the treatment area, she was slumped down in her wheelchair with a left-sided facial droop. As the staff assisted her onto the stretcher, they recognized her garbled speech and delayed responses as symptoms of a possible acute ischemic stroke (AIS).Approximately 1 hour before arrival, the patient experienced a sudden onset of confusion and weakness while in a meeting at work. As the patient stumbled out of the meeting, her coworkers noticed something was wrong. Recognizing the symptoms of stroke-that is, garbled speech, left-sided weakness, and facial asymmetry -they rushed her to the nearest community emergency department (Figure 1).