[Prevention of thromboembolism in heart infarct, cardiomyopathy and atrial fibrillation].
Considering only the clinically relevant endpoints death, pulmonary embolism and arterial embolism, and with the aim of preventing all three, the only established prophylaxis for thromboembolism during the hospital phase of myocardial infarction, in non-rheumatic atrial fibrillation and in dilated cardiomyopathy, is full dose conventional anticoagulation with either heparin and/or oral anticoagulants. Platelet inhibitors and low-dose subcutaneous heparin do not adequately prevent pulmonary and arterial embolism. 1. During the hospital phase of acute myocardial infarction, anticoagulation can safely be omitted only in young patients with small non-transmural infarction, who can be mobilized early and have no thromboembolic antecedents. 2. All patients with dilated cardiomyopathy should be anticoagulated regardless of the presence of mural thrombosis. 3. Patients aged over 60 years with non-rheumatic atrial fibrillation should be anticoagulated regardless of the presence of heart failure.
Straub
P W
PW
Medizinische Universitätsklinik, Inselspital, Bern.
D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006493:Heparin
Thromboembolieprophylaxe bei Herzinfarkt, Kardiomyopathie und Vorhofflimmern.