Question

A 76-year-old man with a history of ischaemic heart disease presents with palpitations and shortness of breath. ECG shows atrial fibrillation with an irregularly irregular rhythm at 110 bpm. He has hypertension and diabetes but no history of stroke or TIA. His CHA2DS2-VASc score is 3. What is the single most appropriate management regarding stroke prevention?

Accepted Answer

Start a direct oral anticoagulant such as Apixaban

Answer

No anticoagulation is required as his risk is low

Answer

Start aspirin monotherapy

Answer

Offer dual antiplatelet therapy with aspirin and clopidogrel

Answer

Offer warfarin only if he develops heart failure

Practice question