Case 15-1995: A 70-year-old woman with atrial fibrillation and the rapid onset of hemorrhagic manifestations

Presentation of Case A 70-year-old woman was admitted to the hospital because of obtundation, aphasia, and a right hemiparesis. She had a five-year history of treated hypertension. Four months before admission a lumpectomy was performed because of breast carcinoma, with normal findings on examination of axillary lymph nodes, and radiation therapy was begun. Forty-six days before admission the patient entered another hospital because of the onset of atrial fibrillation, and treatment with warfarin and quinidine was initiated. Four weeks before admission a complete blood count was normal except that the platelet count was 130,000 per cubic millimeter. The patient felt.