A 65-year-old man presents with melena and hypotension. After initial resuscitation, his blood pressure stabilises. He is taking ASA for secondary pre...

Question

A 65-year-old man presents with melena and hypotension. After initial resuscitation, his blood pressure stabilises. He is taking ASA for secondary prevention and warfarin for atrial fibrillation (INR 3.2). According to GI bleeding and anticoagulation principles, which statement best reflects current practice?

Accepted Answer

Reverse warfarin with vitamin K and/or PCC while balancing thromboembolic risk, and restart anticoagulation after haemostasis

Answer

Continue warfarin and ASA during active bleeding

Answer

Permanently stop all antithrombotic therapy in all patients after GI bleed

Answer

Delay endoscopy until INR is completely normal

Answer

Use platelet transfusion routinely in all cases

ca-mccqe1 MCQ (SBA): GI bleed on warfarin - reversal and restart