# Tia



## naserdoc (Jun 29, 2011)

i had my inpatient admitted from ER with history of TIA ( rt sided weakness and slurred speech ) for 20 minutes at home. hes K/O AF was not on warfarine , when i saw him he was completely passed the attack and there was no further signes noticed. CT brain was negative on first and second days.
   5 days he was put on warfarine 4 mg, lovenox 1mg/KG and kept his old ASA 81 mg , his INR never raised more than 1.4 , !!  oon the 5th day he developed another attack of TIAn with similary signs,. CTS also showed no further changes ( bleeding or infarction) and no atrophic changes. carotid was normal. i stopped his ASA and now hes ion titrating higher dose of warfarine and heparine 5000 SC,  
does any body has any further comment what should be done more?


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## boingo (Jun 29, 2011)

Was a CT angio done?


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## Smash (Jun 29, 2011)

What was his ABCD2 score? If his carotids were normal, maybe get a CT angio. Consider adding dipyridamole if he will tolerate it, otherwise it seems aa though he is medicated to the eyeballs.  His next one will be a bleed!  Is he on a statin?  Put him on one if he isn't.   Was he in hospital for 5 days, or had he been discharged? 
Depending on his risk stratification send him home to have another one or keep him there for a bit longer to have another one. 

Finally, why are you asking me? I'm just an ambulance driver!


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## silver (Jun 29, 2011)

Smash said:


> Finally, why are you asking me? I'm just an ambulance driver!



Didn't you know we (EMTLife) do consults now?


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