A 65-year-old man with a mechanical mitral valve prosthesis is admitted to ICU with a large intracerebral haemorrhage. His INR is 3.5 on warfarin. He ...

Question

A 65-year-old man with a mechanical mitral valve prosthesis is admitted to ICU with a large intracerebral haemorrhage. His INR is 3.5 on warfarin. He has a GCS of 8 and a neurosurgically significant haematoma. What is the immediate priority?

Accepted Answer

Reverse anticoagulation with IV PCC and IV vitamin K despite the mechanical valve - life-threatening ICH takes priority

Answer

Continue warfarin to prevent valve thrombosis

Answer

Perform a lumbar puncture

Answer

Start IV heparin

Answer

Administer oral vitamin K only

uk-fficm MCQ (SBA): ICH with Mechanical Valve

A 65-year-old man with a mechanical mitral valve prosthesis is admitted to ICU with a large intracerebral haemorrhage. His INR is 3.5 on warfarin. He has a GCS of 8 and a neurosurgically significant haematoma. What is the immediate priority?