A patient is taking rivaroxaban (Xarelto) for atrial fibrillation. What is the most concerning complication this patient is at risk for in the dental chair?

Correct answer: A. Stroke

• A. Correct. Rivaroxaban is prescribed for atrial fibrillation primarily to PREVENT stroke (thromboembolic event from blood clot in the atria). A patient on this medication has AF, which carries inherent stroke risk. Additionally, rivaroxaban affects bleeding — but the underlying condition (AF) puts this patient at risk for stroke.
• B. Hypoglycemia is related to diabetes medications — not anticoagulants like rivaroxaban.
• C. Hypertensive crisis is not a direct complication of rivaroxaban.
• D. Angina is a cardiac event related to coronary artery disease — rivaroxaban does not directly cause angina.