Long-term Stroke Prevention in Medicine / Internal Medicine — 45yo Woman | Cardiology | SMLE Q#11789

SMLE Question #11789

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 45-year-old woman has chronic atrial fibrillation and moderate-to-severe rheumatic mitral stenosis on echocardiography. She is hemodynamically stable, has normal renal function, and has no prior stroke or major bleeding. She is not pregnant and is not currently taking any anticoagulation. Which medication is most appropriate for long-term stroke prevention?

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