Had Blood Clot In Arm. On Warfarin. Noticed Brown Discoloration In Feet And Calf Area. Any Advice?
Thank you for writing in.
I am a qualified cardiologist and have read your mail, including the background with diligence.
In persons with atrial fibrillation(AF) specially lone AF(without rheumatic valve disease- mitral stenosis) arterial embolization is a common phenomenon. This is especially in those who are not on blood thinners or anticoagulants (aspirin, clopidogrel and coumadin group of drugs). In you anticoagulant coumadin- Warfarin was started after the event? Or for last one year you are on it that is how long after AF this was started?. Subsequent will depend upon re establishment of blood flow with dissolution of thrombus in a particular limb. I notice that establishment of blood flow has occurred after intervention by vascular surgeon.
Light brown discoloration of your feet and calf area does not mean everything is fine there. I am afraid you have to consult a cardiologist and a Doppler examination of lower limbs starting from lower part of aorta will give some idea. You may need an arteriogram of lower limb vessels. Perhaps CT angiography is also possible these are definitive investigations. My personal feeling is still there is organised thombus partly occluding flow to your both lower limb vessel. Management can be planned after you have seen and examined by vascular surgeon. Please do not stop warfarin till your doctor advises it and substitutes with some milder blood thinners. If you have any further question from me please do ask I will be happy to answer asap. If none you can close the query with comments.
With Best Wishes
Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
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