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Topics:
Listed below is the full complement of educational material currently available to all patients of the Cardiovascular Department: |
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4 What is Signal Average Electrocardiography (SAECG), Ambulatory Holter Monitoring, a Trans Telephonic Event Recorder? 
4 What is Pediatric Echocardiogram? What is Fetal Echo?
4 What is an Implantable Cardiac Defibrillator (ICD)?
4 What is a Pacemaker Follow-Up?
4 What is a Stress Test? New
4 Post Therapeutic Cath Discharge Instructions New
4 About Your Heart Attack New
4 Stress EKG New
4 Stress Echocardiography
4 Transesophageal Echocardiography (TEE)
4 EKG and Echocardiogram
4 Warfarin (a medication)
4 Patient Guidelines for Medication and Anti-Coagulation Therapy
What is Signal Average Electrocardiography (SAECG)?
Signal Averaged ECG is a non-intensive test, which involves attaching electrodes to the body surface. This test identifies patients at high risk from ventricular tachyarrhythmias and sudden cardiac death. The procedure takes 45-60 minutes.
What is Ambulatory Holter Monitoring?
Ambulatory ECG Holter Monitoring is a widely used non-intensive test to evaluate cardiac abnormalities. It is used to continuously examine the heart rhythm over an extended period of time, generally 24 hours. It takes 25-30 minutes to fit the recorder and 5-10 minutes to remove the recorder when the patient returns.
What is a Trans-Telephonic Event Recorder?
The Trans-Telephonic Event Recorder is a patient activated cardiac event recorder, designed to record the heart rhythm over certain periods of time when the patient has symptoms. It takes 30-45 minutes to teach the patient about this device. The patient keeps it with him/her for prolonged periods of time.
What is Pediatric Echocardiogram?
Pediatric echo is also a non intensive, procedure used in the diagnosis and management of heart and, or vascular diseases in the young.
Echocardiography involves the process of obtaining and displaying echocardiographic information to answer specific questions regarding the size of heart valves, structural function and hemodynamic characteristics of the heart and/or blood vessels.
This procedure sometimes requires sedation of patient that makes it a little bit longer than adult echo, about 1-1/2 to 2hours.
What you should “Know” And “Do” Before the Ehocardiogram?
1- No eating or drinking 2 (two) hours before the test because sedation (medication to make the patient sleep) may be given.
2- No eating or drinking after the test, until the child is fully awake from the sedation (usually 2 hours after the test).
What is Fetal Test?
A fetal echocardiogram is a study performed on a fetus through the martial abdomen usually after the 16th week of pregnancy. It is not harmful to mother or the fetus.
The examination includes a complete echo-cardiographic and Doppler study, whereby measurements are made to properly evaluate the heart size and function of the fetus.
This particular non-intensive procedure takes approximately an hour to complete.
What is Sedation?
4Children need sedation that helps them calm down and sleep to do echocardiography. Usually children below 3.5 years are sedated and sometimes sedation is used for children more than 3 years old.
4Sedation may take up to 2 hours; the drug used is chloral hydrate, which can induce sleep.
4The nurse will monitor the child from the beginning of sedation.
4This includes watching blood pressure, respiration, oxygen saturation and heart rate.
4Children will be monitored until fully recovered from sedation and won’t leave the lab until the child is awake and responding.
Cardiac Defibrillation is a way to return an abnormally fast or disorganized heartbeat to normal with an electric shock. An implantable cardiac defibrillator is a lifesaving device that is put inside your body.
How does it work?
4For people with very bad rhythm problems, a defibrillator is implanted under the skin of the abdomen that runs from it to your heart.
4It can detect when the heartbeat is abnormal.
4It tries to return the heart beat to normal by giving an electric shock.
4It works 24 hours a day.
4New models can both give defibrillation shocks and work as a pacemaker.
How do I live with it?
4Visit your doctor on a regular basis.
4Talk to your doctor about your activities.
4Stay away from magnets and strong electrical fields.
4At the airport, tell the guards not to use hand-held metal detectors on you. Show the airport staff your special I.D. Card.
4If you go to a hospital, tell the doctors and nurses that you have an implanted cardiac defibrillator.
4Carry the special ID card supplied by the hospital.
Doctor’s Order
4Ask your doctor to list what you can and cannot do when you have an implanted defibrillator.
Example: Don’t risk going up on a ladder to clean the roof.
How can I learn more?
4Talk to your doctor.
4In case of any questions contact the following number.
Tel : 6677777 Ext: 7489,7490
What is a Pacemaker?
A pacemaker is a small unit that uses batteries to help your heart beat more regularly. It does this with small electric impulses that help to control your heartbeat. Your doctor puts the pacemaker under the skin, just beneath your collarbone. It is hooked up to your heart with tiny wires.
You may need a pacemaker to keep your heart contracting and pumping blood. This way your body gets the blood and oxygen that it needs.
With a pacemaker, your heart should pump almost as well as it normally should. Today many people with pacemakers lead full active lives.
Why would I need one?
4Your heartbeats beat too slowly
4Your heartbeats beat irregularly
4There’s a block in your heart’s electrical pathways.
How does it work?
4A pacemaker uses batteries to send electric signals to your heart to help it pump the right way.
4An electrode is put next to your hart. Tiny electric charges that you can’t feel move through the wire to your heart.
4Many modern pacemaker works only when needed. They’re called “Demand” pacemakers. They shut off if your heartbeat is above a certain rate. They work when your heartbeat is too slow.
How do I live with my pacemaker?
4Your doctor will teach you how to know when you need new batteries and how to replace them.
4Take your medicine the way your doctor tells you.
4Tell your doctor if you have trouble breathing, if you gain weight or get puffy legs or ankles, or if you faint, blackout or become dizzy.
4Follow all doctors’ orders and keep your appointments.
4Carry an I.D. card in your wallet so others know you have a pacemaker.
4Tell your doctors and your dentist that you have a pacemaker.
4Tell airport security that you have a pacemaker and show them your I.D. card.
4Household microwaves and electricity DO NOT affect your pacemaker. If you work around industrial microwaves, electricity, cars or other large machines, ask your doctor about possible effects.
Do I have to take it easy?
4Most people lead full lives with their pacemaker.
4It’s good to do some physical activity.
4You can exercise if your doctor says so.
4You shouldn’t over do it- stop before you’re tired.
4You can have sex.
4How can I learn more?
4Talk to your doctor.
Why do I need a stress test?
A stress test sometimes called a treadmill test or an exercise test. It helps your doctor to find out how well your heart handles work. As your body works harder during the test, it requires more fuel and your heart has to pump more blood. The test can show if there is a lack of blood supply through the arteries that go to the heart.
The test will take 30-60 minutes. Taking a stress test also helps your doctor know the kind and level of exercise that’s right for you.
What happens during the test?
4You’re hooked up to equipment to monitor your heart. Tiny wires or electrodes will be hooked up to your chest and shoulders.
4You walk slowly in place on the treadmill while the speed and incline will gradually increase. It makes you feel as if you’re going up a small hill.
4You can stop the test any time.
4Afterwards you’ll lie down and your heart and blood pressure will be checked.
What is monitored during the test?
4Your heart rate
4Your breathing
4Your blood pressure
4Your electrocardiogram (ECG or EKG)
4How tired you feel
What equipment is used?
4A Treadmill with an ECG heart monitor electrocardiogram (e-lek-tro-KAR-de-o-gram) will record your heartbeat.
Is there a risk?
4There’s very little risk- no more than if you walked fast or jogged a big hill.
4Medical professionals are on hand on case any thing unusual happens during the test. 4You will be asked to sign consent after the procedure has been explained to you.
Tell your doctor if…
4You take medication
4You experience discomfort, shortness of breath or dizziness.
How long?
4Plan to arrive early to allow for check-in.
4Test usually takes 30-60 minutes.
Afterwards
4Resume normal activity
4Follow your doctor’s instructions
Special Note
4Not 100% accurate in finding or predicting heart problems.
4Complications are rare.
FIRST: ACTIVITY
Follow this instructions for two weeks
4Avoid any physical activity that may increase your heart rate more than 110 beat/minute.
4Increase your activity gradually.
4Do not lift any heavy object.
4Do not bend forward from the hip for a prolonged period.
4You have to perform prayer on a chair.
4You can use the stairs carefully, up & down, do not run.
4No sexual intercourse.
4Do not drive your car ask someone else to drive you.
SECOND: DIET AND MEDICATION
4Take your medications regularly as prescribed upon discharge.
4You have to strictly follow the low salt, low fat, and the diabetic diet if you have diabetes (avoid the animal fats, red meat, chicken skin. Try to take the white meat instead as fish & chicken. Use lemon instead of salt.)
THIRD: SMOKING
4Smoking is strictly (PROHIBITED)
FOURTH: Contact Emergency If needed
If you developed any of the following, please contact the emergency department on 026677777 ext 5557 or 5559 or come direct to the emergency:
4Unexplained fever or sweating.
4Bleeding at the site of catheterization.
4Swelling or discoloration at the site of catheterization.
4Chest pain similar to the pain you had before the cardiac catheterization.
Fifth: LOW SALT DIET
If you have high blood pressure it is advisable to follow a diet low in salt & salty food, the following list will help you:
4Avoid adding salt to your food, use lemon, pepper (not spicy) instead.
4Limit use of tinned & processed meats like burgers, frankfurters and cold cuts.
4Avoid using flavoured coatings on meat, chicken and fish.
4Choose fish tinned in oil or tomato sauce rather than in brine. Avoid salted or smoked fish.
4Rinsing canned vegetables and fish will remove much of the salt.
4Avoid olives, salted nuts and crisps.
4Choose low salt cheese and limit use of condensed or evaporated milk.
4Avoid packet and tinned soups and sauces.
4Avoid stock cubes, fish sauces, meat and vegetable extracts and soya sauce.
4Use fresh or frozen vegetables instead of tinned or pickled varieties.
4Avoid Mankoushi (cheese or thyme coated bread and pastries).
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Heart Attack
You’ve been through a Lot!
As you are so well aware, experiencing a heart attack fills people with emotions ranging from fear to anger to depression. A heart attack is a traumatic experience that can impact entire families. What’s so important to remember, however, is that you are far from alone, and medicine has made tremendous strides in treatment over the past 30 years.
One of the first things you should know is that fear, worrisome, anger, and depression are all common feelings for people who have experienced a heart attack. You may discover that after your heart attack, you begin to worry about even the slightest twinge of pain when you would never have even noticed it before the heart attack. Or you may feel depressed. You may think that your life as you had known it before your heart attack is over and now you’ll be forced to act like an “old” person. Can you still work? Can you play with children?
Or, you may feel angry that something like this could happen to you. Who could have done this to you? Did people over-stress you at work? Were you worried about financial matters?
The worries and fears will go away with time. As your heart muscle becomes stronger, you will begin to believe that you are not so fragile after all. You’ll start to see that you can do many of the things that have always been important to you. You’ll even see that a heart attack doesn’t compromise sexual potency. One thing to remember is that a heart attack is not caused by anyone. Nobody can “give” anyone a heart attack. While there are things you can do to minimize your risk of suffering a heart attack, and there are stresses that may precipitate the attack, heart attacks are caused by a long complicated process, which you will learn a little more about in the next few pages.
As difficult as it might be to believe this right after your heart attack, your heart will heal, and you should return to your normal activities. 80% to 90% of people who experience heart attacks return to work with in 1 to 3 months. Naturally, your return to work depends on how extensive the damage to your heart was and how physically demanding your job is.
Exactly What Happens?
Plaque is a fatty deposit that collects on artery walls. Sometimes, when plaque becomes unstable, it can burst and cause a blockage in the artery. Or the plaque may break off and travel through the body and cause a blockage elsewhere. When this blockage happens in an artery that supplies blood to the heart, some muscles of the heart become damaged, and the result is a heart attack.
Why Heart Attacks Come by Surprise?
Atherosclerosis doesn’t always cause any symptoms or warnings. It is a gradual and complicated process that results in a clot forming in the artery. This clot can block blood flow to the heart, and a heart attack occurs. However, the human body has a remarkable ability to adapt to changing circumstances, and often, other unaffected vessels work to compensate for the diminished blood flow. When this occurs, it helps people either avoid a heart attack or recover after one.
Heart attacks can also be initiated by stress. If someone runs for a bus suddenly, they can increase their blood-flow needs. But if they have hardened arteries, their body may not be able to meet the heart’s requirements, and a heart attack can result. It is important to note that regardless of what initiates the heart attack, it takes a long and complicated process to develop the underlying atherosclerosis. It is important to remember that heart attacks are common, and the good news is that most people who suffer from a heart attack go on to live healthy, productive lives.
Do Heart Attacks Lead to Stroke?
People who have had a heart attack are at increased risk of having a stroke. Remember, however, that there are many things you can do to live a healthier lifestyle to minimize your risk of having a stroke.
The term Stroke or “Brain Attack” refers to damage to the brain that results when the brain is denied blood flow. Sometimes a blood clot can from in an artery (anywhere in the body) and then break off and travels through the vessels. A blood colt, called a thrombus, can travel through the vessels and can lodge in a small vessel anywhere in the body. When the colt travels to the brain and decreases the flow of oxygen there, it causes stroke.
The amount of heart muscle damage determines the severity of the heart attack. Once the heart muscle is damaged, the heart has to work harder to make sure that blood is supplied to the body, making the heart more susceptible to a second heart attack. Over time, the heart can recover from this damage, and many people who have had a heart attack can return to normal activities.
What Can You Do to Keep This Form Happening Again?
So much has been learned about atherosclerosis and what can be done to slow its progression and more importantly, there have been tremendous strides made by researchers to develop medications to minimize the risk of second heart attacks. Your doctor has prescribed pravastatin for you. Pravastatin helps protect you from another heart attack or stroke.
Pravastatin in conjunction with your other medications, along with proper diet, exercise, and rest, will put you on the road to a healthier life.
No matter how you feel emotionally, there are THREE THINGS you must remember:
4You will feel better over time.
4You will feel better over time.
4You will feel better over time.
HEART speak
4Atherosclerosis
The condition of having a fat buildup in the arteries.
4Coronary thrombosis
A blood colt is blocking an artery that supplies blood to the heart.
4Myocardial infraction
Heart attack
4Embolism
A blood colt that breaks off and travels through the arteries.
4Plaque
Deposit of fats and other body cells that collects in arteries.
4Stroke
The damage caused to the brain by blocked blood supply.
4Thrombus
Blood colt
STRESS EKG
Evaluating your heart’s Response to Exercise
The stress EKG (electrocardiogram), or tress test, conducted while you exercise on a treadmill or stationary bicycle, measures your heart’s health under the stress of physical activity. Your blood pressure and pulse are also monitored by a specially trained technician, an expert in using stress test equipment.
Results will be evaluated by a cardiologist or your physician. The stress EKG aids in determining how fit you are and how safe an exercise program is for you, or if a heart problem exists.
Getting Ready
4Your doctor will give you specific instructions.
4You will be asked not to eat or smoke before.
4You may need to avoid some medications.
4Wear loose-fitting clothes and comfortable walking shoes.
Exercise and your heart
The heart is a muscle that pumps blood throughout your body, distributing life-giving oxygen to all the cells. If the heart is not working properly, an EKG at rest often can show the problem. During exercise, however, the heart beats faster because the body needs more oxygen when stressed.
The stress EKG provides even more specific information about how your heart and coronary arteries are functioning.
How the Stress EKG Works?
The stress EKG for your heart is like test driving a car before you buy it. You have to take it out on the road to see how it really performs. The stress EKG does not always give 100% accurate information, but the doctor can usually determine the presence or absence of a heart problem. The stress EKG often detects heart disorders missed by an EKG taken while you lie at rest. Blood pressure, when measured during exercise, helps determine your blood pressure pattern and how well your heart is working.
What Happens During a Stress EKG
4The technician will place electrodes, or metal discs, on your arms, shoulders, and chest. These electrodes are connected by wires to the electrocardiograph machine.
4An EKG at rest will be taken first.
4You will then step onto the treadmill or stationary bicycle and exercise according to your doctor’s instructions.
4Your blood pressure and pulse are checked during and after the test.
4If you experience shortness of breath, dizziness, tiredness, or discomfort, tell the doctor or technician.
The Thallium Exercise Test
Your doctor may order a thallium stress test for more information. Toward the end of the stress test, a small amount of radioactive thallium is injected into a vein. The amount of radiation is minimal. A special camera is used to image the heart.
Finding Out the Results
Your doctor will have the results of your stress EKG in 1-2 days and will explain these results to you. He or she may decide your need and more tests or treatment will be discussed this with you. Your doctor will also help answer any questions about your exercise program.
Tell Your Doctor If …
4You are taking medications.
4You experience discomfort, shortness of breath or dizziness.
How Long?
4Plan to arrive early to allow for check-in.
4Test usually takes 30-45 minutes.
Afterwards
4Resume normal activity.
4Follow your doctor instructions.
Special Note
4Not 100% accurate in finding or predicting heart problems.
4Complications are rare.
STRESS ECHOCARDIOGRAPHY
Recording your heart’s response to exercise
Stress echocardiography, or stress echo, is an exercise test that helps your doctor see how well your heart pumps when made to beat harder. Harmless sound waves bounce (echo) off your heart. The sound waves show the structure and movement of your heart before and immediately after exercise. By comparing the images taken before and after exercise, your doctor can see any changes in the way of your heart muscle works when under the stress of exercise. This tells your doctor whether your heart is getting enough blood to meet its increased demand for oxygen.
How Stress Echo Works?
During a stress echo, a transducer (a small device that produces sound waves) is placed on your chest both before and immediately after you exercise. The sound waves bounce off your heart and are changed into images on a video screen. The doctor compares the two images to detect any changes in the way your heart responds when you exert yourself.
Before Your Stress Echo
4Wear a two-piece outfit and shoes that are comfortable for exercising.
4Don’t eat for 3 to 4 hours before the test.
4Ask your doctor if you should take your usual medications that day.
During your stress echo
After you arrive for your stress echo, you’ll be asked to undress from the waist up. Women are given a hospital gown to wear. A technician places a painless transducer at various places on the left side of your chest. Then pictures of your heart at rest are recorded on videotape. Your blood pressure is also monitored, and electrodes are attached to your chest to record an electrocardiogram (EKG), a test that records the pattern of your heartbeat.
Next, you’re asked to walk on a treadmill or pedal a stationary bicycle until your heart is beating rapidly. If you have a medical condition that prevents you from exercising, your heart rate may be increased with medication instead of exercise. This kind of stress echo is often done in a hospital.
Finally, a technician records a second set of video images of your heart immediately after you finish exercising. The doctor can then display the two sets of images side by side to compare the way your heart functions at rest and after exercise.
Finding Out the Results
In some cases, the doctor may be able to tell you the test results before you leave. Or, you and your doctor will discuss the test results at a later appointment. The information gained from stress echo will enable your doctor to plan your treatment and to decide whether any additional tests are necessary.
Tell Your Doctor If …
4You regularly take any medications.
4You experience pain in your chest, shortness of breath, dizziness, or fatigue during the test.
How Long?
4Plan to arrive early to allow for check-in.
4Allow 1-2 hours from arrival to the time you can leave.
Afterwards
4Resume your normal activity.
4Follow up with your doctor to discuss the results of your test.
Special Note
4Stress echo is painless, noninvasive, and involves little risk. Your doctor will discuss any possible risks of exercise with you.
Transesophageal Echocardiography (TEE)
A closer Look at your Heart
Transesophageal Echocardiography (TEE) is a test that allows your doctor to record images of your heart from inside your esophagus, or food pipe. Since the esophagus lies gust behind the heart, TEE may produce clearer pictures of the heart’s movement than would standard echocardiography taken from outside the chest.
During TEE, harmless sound waves bounce (echo) off your heart. These sound waves create images of your heart as it pumps blood through the valves and chambers. These images help your doctor identify and treat problems such as infection, disease, or defects in your heart’s walls or valves.
How TEE Works?
A flexible tube about the size of your index finger is inserted into your mouth and down your esophagus. At the tip of the tube is a small probe that produces sound waves. The sound waves bounce off your heart and are changed into pictures on a video screen. The doctor can move the probe up, down, and sideways to look at different parts of your heart from different angles. Your throat is numbed, so you should feel little or no discomfort during the procedure.
Before Your TEE
4Don’t eat or drink for 4-6 hours before your exam. Take any prescribed medications with a sip of water only.
4Arrange to have someone pick you up after the exam. Don’t plan to drive your self home, as you may be drowsy.
During your TEE
4When you arrive for your TEE, you will change into a hospital gown, and then be taken to the testing room.
4Your throat is sprayed with an anesthetic to numb it. You may be given a mild sedative through an IV (intravenous) line in your arm to help you relax. You may also be given oxygen. If you wear dentures, you’ll need to remove them. Then you will be asked to lie on your left side.
4The doctor gently inserts the probe into your mouth. As you swallow, the tube is slowly guided into your esophagus. The tube is lubricated to make it slide easily.
4You may feel the doctor moving the probe, but it shouldn’t be painful or interfere with your breathing. A nurse monitors your heart rate, blood pressure, and breathing during the test, which usually takes 20-40 minutes.
Finding out the results
Because sound waves travel very fast, images of your heart are recorded almost instantaneously. The doctor may be able to show you the videotape and discuss your test results before you leave. Or your doctor may discuss the test results with you at a later appointment. Your doctor will use the test information to plan your treatment and to decide whether additional tests are necessary.
Tell Your Doctor If …
4You take any medications or have ulcers, a hiatal hernia, or problems swallowing.
4You have allergies to any medications or sedatives.
The Time it Takes
4Check with the doctor for arrival time. Allow plenty of time so you won’t be late.
4Allow 1-2 hours from your arrival to the time you can leave.
Afterward
4If you have sedation, don’t drive for 12 hours.
4Don’t eat or drink until your throat is no longer numb.
4Follow any instructions your doctor gives you.
Special Note
4If your throat is sore, soothe it with cold drinks and lozenges.
4Report unusual symptoms, such as bleeding, internal pain, or a stiff neck, to your doctor.
EKG and Echocardiogram
Understanding Your Heart
The electrocardiogram, or EKG, is a test that measures your heart’s electrical activity, and thus helps your doctor determine your heart’s health. An EKG can assess heart damage and disease, and is almost routine in persons over 40. An Echocardiogram, or Echo, produces images of the heart by using sound waves. These images can help identify abnormalities of heart muscles or valves and fluid around the heart.
Both EKG and ECHO are performed by a specially trained technician. A physician who is an expert in interpreting these tests will report the results to your doctor. Both EKG and ECHO may be done in your doctor’s office.
Getting Ready
4No special preparations are necessary.
4Wear loose, comfortable clothing that allows easy access to the chest.
4For best results, try to relax.
How an EKG Works
The EKG is a test that records electrical signals from your heart onto a paper strip. The pattern of these signals can tell the physician whether your heart is normal, under stress, experiencing electrical problems, strain, or damage.
The Heart’s Electrical System
Your heart’s continuous beating is controlled by a natural pacemaker (SA node). The pacemaker sends electrical signals to the many cells in the heart muscle. These signals cause the heart muscle to contract and pump blood throughout your body.
What Happens During an EKG
4The technician will ask you to remove your clothing from the waist up and lie down on your back.
4Electrodes, or metal discs, with conductive gel are placed on each wrist and ankle and at six points on your chest by suction cups or straps.
4After a few minutes of recording, the technician will remove the electrodes or metal discs.
4The results will be sent to your doctor.
How ECHO Works?
During ECHO, harmless sound waves are bounced off your heart, then beamed back and converted to images on a screen. These images are used to see the structure and movement of the heart’s valves and chambers. A Doppler ECHO may be used in the same way, bouncing sound waves off heart chambers and blood vessels to view blood flow patterns and valves.
What Happens During an ECHO?
4You will be asked to remove the clothing on your upper body or the left side of your chest.
4A small device (ECHO transducer) will be lubricated with gel and the technician will hold it in various places on your chest. You may be asked to lie in different positions. Electrodes are attached to your wrists, ankles, and chest record a simultaneous EKG.
4After obtaining the necessary information, the technician will remove the transducer and electrodes. The results are sent to your doctor.
Finding out the Results
Your doctor will discuss the results of the EKG or ECHO with you. The EKG may be read immediately, or results will be ready in about one day. Results from the ECHO take 1-2 days. Your doctor may recommend additional tests or treatment, depending on your diagnosis.
Tell Your Doctor If …
4You are taking medications.
4You experience any chest discomfort.
How Long?
4Plan to arrive early EKG’s take less than 10 minutes.
4ECHO’s take less than 45 minutes.
Afterwards
4Resume normal activity.
4Follow your doctor instructions.
Special Note
4EKGs and ECHOs are valuable diagnostic tools.
4They are painless and involve no risks.
WARFARIN
What is the brand name?
4Coumadin
4Marevan
How does it work?
Keeps blood clots from forming or getting larger.
How should I take it?
4Your doctor will tell you how much to take and how often.
4This medication comes as tablets of different strength and colors may be taken as a single dose over 24 hours (with or without food) with a full glass of water.
4Don’t stop taking your medication without consulting your doctor.
When you should not take it?
4Don’t take if you’re pregnant or planning to become pregnant.
4If you have an allergic reaction to it.
What should I avoid?
4Avoid taking any other medicine including over-the-counter products without asking your doctor or pharmacist.
4Make sure your doctor knows if you are taking aspirin or products that contain aspirin.
4Avoid taking this medication when you are pregnant or breast feeding.
4You should carry an identification card that shows that you are taking Warfrin before you have any surgery or dental work.
4Avoid taking dietary supplement that contain additional vitamin K.
What if I miss a dose?
4Take the missed dose as soon as possible.
4If you don’t remember until the next day, skip the missed dose. Only take your usual dose for the day
4DON’T take two doses at the same time.
What about my diet habits?
4Follow doctor instructions carefully.
4Try to eat about the same amount of food that contains vitamin K (such as lettuce, spinach, broccoli, or liver) each day.
What side effect can this drug cause?
4It can cause bleeding from the gums or nose.
4Sudden appearance of bruises, excessive menstrual bleeding, headache and stomach pain.
What should be monitored?
4It is very important to have regular blood tests done to determine the proper and safe dose. It is common while taking this medicine to have your dose changed.
When should I contact my doctor?
If you have these side effects:
4Severe bleeding from the gum.
4Coughing up blood.
4Red or black bowel movements.
4Red or dark-brown colored urine.
4Unusually heavy menstrual bleeding.
4Heavy bleeding from cuts or wounds that does not stop.
4When you become pregnant while being treated with this medicine.
4Any signs of reactions like wheezing, tightness, itching, bad cough, swelling of face, lips, tongue, or throat.
How should I store it?
4Keep it in its original container out of reach of children.
4Store at room temperature, away from heat, light, and moisture.
This is a medicament
4Medicament is a product that affects your health and its consumption contrary to instructions is dangerous for you.
4Strictly follow the doctor’s prescription, the method of use and the instructions of the pharmacist who sold the medicament.
4The doctor and the pharmacist are experts in medicine, its benefits and risks.
4Do not by your self interrupt the period of treatment prescribed for you.
4Do not repeat the same prescription without consulting your doctor.
COUMADIN (Warfarin)
Coumadin (Warfarin) is a blood thinner which affect vitamin K in the body. Therefore, it is better to reduce the intake of foods which contain vitamin K. These foods are: green leafy vegetables such as spinach, broccoli, molokhia, green lettuce, turnip green, cabbage, green cauliflower, dry green tea, soybean oil, chick peas, and beef liver.
“Don’t change your eating habits”
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