Key result
Dabigatran treatment in a 91-year-old male with atrial fibrillation triggered a cerebral infarction hemodynamically due to bradycardia and hypotension associated with gastrointestinal bleeding.
Case Report (n=1)
This case highlights that dabigatran-induced gastrointestinal bleeding can lead to renal failure and digitalis toxicity, culminating in hemodynamic cerebral infarction.
May prompt closer monitoring of elderly AF patients on dabigatran; hypothesis-generating and leaves open broader risk assessment.
A 91 year-old male who was orally receiving dabigatran and digitalis for chronic arterial fibrillation was hospitalized for cerebral infarction (CI). The complications of anemia due to gastrointestinal bleeding and the development of renal failure were also found, which enhanced the effect of digitalis. This enhanced drug action induced bradycardia and hypotension. The hypotension was improved by implanting a temporary pacemaker, and the neurological abnormal findings also disappeared with the improved blood pressure. In many cases, dabigatran is efficient in preventing CI, but in our case it in fact triggered a CI hemodynamically due to bradycardia and hypotension with gastrointestinal bleeding.
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Nishizaki et al. (2015) conducted a case report in Chronic atrial fibrillation (n=1). Dabigatran and digitalis was evaluated on Cerebral infarction. Dabigatran treatment in a 91-year-old male with atrial fibrillation triggered a cerebral infarction hemodynamically due to bradycardia and hypotension associated with gastrointestinal bleeding.
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