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Antithrombotic Therapy in Valvular Heart Disease

Deeb N. Salem, MD, FCCP, Chair; Denise Hartnett Daudelin, RN, MPH; Herbert J. Levine, MD; Stephen G. Pauker, MD; Mark H. Eckman, MD; Joshua Riff, BSc
Author and Funding Information

Correspondence to: Deeb N. Salem, MD, FCCP, New England Medical Center, Box 79, 750 Washington St, Boston, MA 02111-1526



Chest. 2001;119(1_suppl):207S-219S. doi:10.1378/chest.119.1_suppl.207S
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Extract

Few complications of valvular heart disease can be more devastating than systemic embolism. It is well recognized that antithrombotic therapy can reduce, although not eliminate, the likelihood of this catastrophe. If this therapy were risk free, all patients with valvular heart disease should be treated. Unfortunately, antithrombotic therapy, particularly with coumarin derivatives or heparin, carries a substantial risk of bleeding; this risk varies with the drug used, the intensity of the anticoagulant effect, and the clinical circumstances in individual patients. For example, risks of anticoagulant therapy are greater in patients with endocarditis, pregnancy, and bleeding diatheses.

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