title: Myocardial infarction complicated by left ventricular thrombus and fatal thromboembolism following abrupt cessation of dabigatran.
abstract: Novel anticoagulants are increasingly utilised in lieu of warfarin to treat non-valvular atrial fibrillation. Their clinical use in other non-FDA approved settings is also increasing. We present a case in which a patient abruptly stopped taking dabigatran due to a small bowel obstruction and shortly thereafter suffered a myocardial infarction complicated by left ventricular thrombosis with fatal embolisation to the superior mesenteric artery. In this context, we discuss the possibility of a rebound phenomenon of hypercoagulability with abrupt cessation of novel anticoagulants.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Bethany
authors.initials: B
authors.lastname: Weiler
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Marciniak
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Reed
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: McCurdy
mesh_terms: D000369:Aged, 80 and over; D000792:Angiography; D000991:Antithrombins / Q000494:pharmacology; D001562:Benzimidazoles / Q000494:pharmacology*; D000069604:Dabigatran; D017809:Fatal Outcome; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D015091:beta-Alanine / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran
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