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What Causes Hematoma On The Upper Arm While On Coumadin?

Posted on Sat, 24 Sep 2016

Question: Dad is 96 and on Coumadin. He stumbled Thursday w his walker. He did not fall but we could not support his weight and lowered him to the floor. We called 911 and they got him off the floor and seated in his wheelchair. He now has a large hematoma on his upper arm, has swelling on 2X2 area of his chest from his right nipple to hit right armpit, and cannot raise his right arm above his shoulder. He is in pain from it. We did not think the ER was indicated, called his doctor, and she agreed that he might just sit in the ER for a while for nothing. Any thoughts?

Answered by Dr. Dr. Ivan Romich (48 minutes later)

Brief Answer:
possible muscle injury

Detailed Answer:
Hi and welcome to HCM. Considering his age and Coumadin intake it is not suprising that such hematomas occur easily. Chest contusions are usually very painful even if there is no fracture and pain may even worsen in next few days. It is important to avoid shallow breathing and take stronger painkillers such as tramadol or diclofenac. His arm may be injured by partial rupture of rotatory manchete. This is muscle that is required for movements in shoulder, He should rest with it and apply colde compresses and immobilize it. In few weeks he should do ultrasound of the shoulder if pain persist Wish you good health. Regards

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Above answer was peer-reviewed by : Dr. Raju A.T