Prevention of systemic arterial embolism in chronic rheumatic heart disease by means of protracted anticoagulant therapy.

Seven clinic outpatients with mitral stenosis and auricular fibrillation complicated by systemic embolism have been maintained on Dicumarol for periods of 20 to 48 months. None has had a recognized embolism while on therapy. Dicumarol administration has been interrupted in each case for periods of six days to four months. Three additional systemic embolic episodes in two individuals occurred during this interval. Hemorrhagic manifestations have occurred on three occasions. The study suggests that: (a) protracted Dicumarol therapy is an effective means of preventing recurrent embolism in individuals with chronic rheumatic heart disease; (b) it is applicable to the average clinic outpatient.