Mechanical Heart Valves and Intracerebral Haemorrhage
Patients with mechanical prosthetic heart valves require oral anticoagulation to reduce the risk of thromboembolic events, but this can be complicated by anticoagulant-associated intracerebral haemorrhage (ICH). In order to make appropriate decisions about the resumption of anticoagulation in patients with mechanical heart valves and ICH, the risks of further bleeding must be weighed against those of thromboembolic events. There is limited evidence available to guide clinical decision-making in this situation and each case must be assessed individually, ideally with a multi-disciplinary team approach.

Patients with a mechanical heart valve prosthesis require oral anticoagulation to reduce the risk of thromboembolic events. However, this can be complicated by anticoagulant-associated intracerebral haemorrhage (ICH). This presents a therapeutic dilemma as regards future anticoagulation. Here we present a case report, and discuss the available evidence used to guide subsequent management.