Key result
Long-term use of warfarin in a 78-year-old woman with a mechanical mitral valve replacement was associated with the development of progressive diffused calcification.
Why the study?
Lifelong warfarin is mandatory after mechanical valve replacement, but rare adverse events associated with long-term use, such as diffused calcification, require reporting and close monitoring.
Does long-term warfarin therapy cause diffused calcification in patients with mechanical valve replacement?
Case Report (n=1)
Does long-term warfarin therapy cause diffused calcification in patients with mechanical valve replacement?
Long-term warfarin therapy may be associated with rare complications such as diffused calcification, warranting close monitoring in patients requiring lifelong anticoagulation.
Diffuse calcification may complicate lifelong warfarin after mechanical valve replacement; this Level 5 case extends the spectrum of rare adverse effects but remains hypothesis-generating.
Background: Lifelong warfarin is mandatory in patients with mechanic valvular replacement. The main adverse effect of warfarin is haemorrhage; however, there are several rare adverse events associated with long-term warfarin treatment, such as calcification, cholesterol microembolization, and nephropathy. Here we report a case of chronic warfarin use that gradually manifested with diffused calcification. Case summary: A 78-year-old woman received a prosthetic mechanical mitral valve replacement when she was 46 years old due to rheumatic mitral stenosis. She has been taking warfarin ever since. Ten years prior to admission, the chest radiography revealed a mild diffused calcification tracheobronchial and subsequent chest imaging indicated a progressive calcification of the tracheobronchial tree. In addition, a series of echocardiography examinations indicated progressive calcific aortic stenosis and diffused calcification in abdominal aorta. Furthermore, the patient gradually presented with advanced heart failure. Finally, she received transcatheter aortic valve replacement and the symptoms of the heart failure significantly improved. Discussion: Currently, patients with valvular atrial fibrillation or mechanical valve replacement have no other choice for anticoagulation medication except warfarin. However, long-term use of warfarin was associated with some rare complications such as diffused calcification. Therefore, close monitoring of such side effects in patients with long-term use of warfarin is warranted.
No takes yet. Share an insight, caveat, or question.
Sasmita et al. (2022) conducted a case report in Diffused calcification (n=1). Warfarin was evaluated on Diffused calcification. Long-term use of warfarin in a 78-year-old woman with a mechanical mitral valve replacement was associated with the development of progressive diffused calcification.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: