martes, noviembre 04, 2008

Desastres de la anticoagulación.


Los efectos beneficiosos del tratamiento anticoagulante es incuestionable.Pero la tendencia a ser cada vez más agresivo y aplicar algoritmos terapeuticos sin singularizar el caso,pueden llevar a complicaciones a veces fatales y en otras ocasiones no fatales pero gravísimas que ponen enpeligro la vida de lpaciente. Esta enferma de 77 años ingresó por una fibrilacion auricular rapida que se controló rapidamente.En el intervalo de solapamiento con Heparina de bajo peso molecular más anticoagulación oral ocurrió una gravisima hemorragia que se coleccionó enlos musculos rectos abdominales prolongandose a la cavidad abdominal. La paciente presentó inestabilidad hemodinámica, precisó 7 Unidades de Concentrado de Hematíes y desarrrolló una Insuficiencia renal aguda. La paciente está restablecida y su problema resuelto. Su Doctor , el Prof. J. Arenas Posada nos ha cedido las imagenes, conla generosidad que le caracteriza.

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