Examen Integrado - Medicina Practice Questions - Argentina Medical Residencies Integrated Examination (Examen Integrado De Residencias De La Salud - Medicina) Exam

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A 72-year-old female with a history of essential hypertension and type 2 diabetes mellitus presents to the outpatient clinic for routine evaluation. A 12-lead ECG reveals irregularly irregular narrow-complex tachycardia without distinct P waves at a rate of 98 bpm, confirming newly diagnosed non-valvular atrial fibrillation. Echocardiogram shows mild left atrial enlargement with preserved LVEF (55%). She has no history of stroke, TIA, or bleeding. What is her CHA2DS2-VASc score, and what is the recommended stroke prevention strategy?

CHA2DS2-VASc score = 4; initiate oral anticoagulation with a Direct Oral Anticoagulant (DOAC, e.g., Apixaban or Rivaroxaban) or Warfarin CHA2DS2-VASc score = 2; initiate dual antiplatelet therapy with Aspirin 100 mg and Clopidogrel 75 mg daily CHA2DS2-VASc score = 1; initiate Aspirin 100 mg monotherapy daily CHA2DS2-VASc score = 3; no anticoagulation or antiplatelet therapy is indicated unless she develops paroxysmal symptoms

Correct Answer:

CHA2DS2-VASc score = 4; initiate oral anticoagulation with a Direct Oral Anticoagulant (DOAC, e.g., Apixaban or Rivaroxaban) or Warfarin

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