Palpitations in Medicine / Internal Medicine — 77yo Woman | Cardiology | SMLE Q#1043

SMLE Question #1043

Medicine / Internal Medicine Cardiology
Last updated: February 2026
A 77-year-old woman with hypertension presents with palpitations and mild exertional dyspnea and is found to have new-onset atrial fibrillation. She is hemodynamically stable. She has no prior stroke, transient ischemic attack, systemic embolism, or major bleeding. She has no mechanical heart valve and no moderate-to-severe mitral stenosis. Renal and liver function are normal. Her CHA2DS2-VASc score is 3. What is the most appropriate long-term stroke prevention strategy?

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