Anesthesia Management of a Case of Subdural Hematoma in a Patient of Severe Mitral Stenosis with Warfarin Toxicity: A Case Report

JOURNAL TITLE: Research and Innovation in Anesthesia

Author
1. Shital H Borkar
2. Sudhams Tarapatala
3. Sunil K Gvalani
4. Pallavi A Kharat
ISSN
DOI
10.5005/jp-journals-10049-0089
Volume
5
Issue
2
Publishing Year
2020
Pages
3
Author Affiliations
    1. Department of Anesthesia, HBT Medical College and Dr RN Cooper Municipal General Hospital, Mumbai, Maharashtra, India
    1. Department of Anesthesia, HBT Medical College and Dr RN Cooper Municipal General Hospital, Mumbai, Maharashtra, India
    1. Department of Anesthesia, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai, Maharashtra, India
    1. Department of Anesthesiology, HBT Medical College and Dr RN Cooper Municipal General Hospital, Mumbai, Maharashtra, India
  • Article keywords
    Mitral stenosis, Pulmonary hypertension, Rheumatic heart disease, Subdural hematoma, Warfarin toxicity

    Abstract

    Valvular heart diseases have a mixed presentation in healthcare settings all over the world. Rheumatic heart disease still forms the major cause of these valvular lesions. Mitral and aortic valvular diseases top the list of valvular pathology.1 Thereby, a thorough understanding of the pathophysiology of valvular heart disease is essential in planning anesthesia and perioperative care of such patients. Judicious use of fluids, close monitoring of the changing hemodynamics, and avoiding major reduction of cardiac output and fluid shifts are mandatory to achieve a good clinical outcome. These patients are at risk of the thromboembolic episode for which they are on long-term anticoagulation.2 So timely monitoring of the coagulation profile is needed. The risk of bleeding increases if international normalized ratio (INR) >4.5.3 We hereby present a case of subdural hematoma in a case of severe mitral stenosis with warfarin toxicity posted for burr hole surgery.

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