Stroke can occur in patients experiencing atrial fibrillation (A Fib). Due to the irregular beating of the heart caused by A Fib, blood clots can build up in the heart. These clots are at risk of being ejected from the heart and traveling to the brain where they cause stroke. Strokes can have devastating consequences for its victims, as well as driving up healthcare costs for all of us. Historically, doctors assessed the risk of stroke in a patient with A Fib using the so-called CHADS2 assessment tool. However, other factors should be taken into consideration based on recent study findings.
The CHADS2 assessment tool is a scoring system where points are giving for each of the following in patients diagnosed with A Fib: congestive heart failure, hypertension, age over 75, diabetes and previous stroke or transient ischemic attack (TIA). New evidence published in the British Medical Journal shows that additional factors can herald increased risk of stroke in this patient population. These factors include: coronary artery disease (atherosclerosis or CAD), age 65-74 years and female sex.
These findings are important since stroke is preventable in such patients. Current standards provide that A Fib patients at sufficiently increased risk of stroke should be placed on anticoagulation, such as Coumadin, to prevent blood clots from forming in the heart. Under Ohio law, when a physician fails to comply with accepted standards of care, and a patient suffers an injury like a stroke, the physician may be held liable in a medical malpractice case.
Brain injury and stroke carry long-term consequences for patients and their families. Physicians owe a duty, recognized by Ohio law and by various medical professional associations, to screen patients for preventable conditions and prescribe preventative treatment strategies when they fall into certain at-risk categories.