Case history
Mr. Bélanger is a man, 67, admitted to emergency in the morning for a feeling of weakness and constant palpitations in the chest. The summary assessment of the patient in emergency identified a de novo atrial fibrillation. The patient says he is tired and feels uncomfortable in his chest area. The clinical examination showed a pulse deficit, specifically, a difference between the radial and apical pulse.
Following IV anticoagulant and antiarrhythmic treatments in emergency to treat the atrial fibrillation, the patient was transferred to your medical department (cardiology). An oral anticoagulant treatment must be started, as well as clinical monitoring of telemetry. You are working in the evening, and you are getting ready to start the patient on Coumadin (warfarin) in your first round. Mr. Bélanger is accompanied by his wife.