Pharmacology · single question
A patient with atrial fibrillation is taking Xarelto (rivaroxaban). What complication is this patient most prone to experience in the dental chair?
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Correct answer: A. Stroke
Atrial fibrillation (AFib) significantly increases the risk of STROKE by causing blood to pool in the atria, forming thrombi that can embolize to cerebral vessels. Rivaroxaban (Xarelto) is an anticoagulant prescribed SPECIFICALLY to prevent stroke in AFib patients by preventing thrombus formation. If the anticoagulant effect is interrupted, missed, or the patient goes into AFib during the appointment, the underlying condition (AFib) makes STROKE the primary risk. Note: Xarelto can also increase bleeding risk during procedures.
- A. CORRECT. Atrial fibrillation causes irregular cardiac contractions, blood stasis in the left atrial appendage, and thrombus formation. These clots can embolize to cerebral vessels, causing STROKE. Xarelto is specifically prescribed for STROKE PREVENTION in AFib.
- B. INCORRECT. Heart attack (myocardial infarction) results from coronary artery occlusion. While AFib increases overall cardiovascular risk, stroke is the most direct and specific complication of AFib.
- C. INCORRECT. Syncope (vasovagal episode) is a common dental chair complication but is not specifically related to AFib or Xarelto.
- D. INCORRECT. Angina is chest pain from myocardial ischemia — associated with coronary artery disease, not primarily AFib.