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A 59-year-old man who was receiving warfarin because of previous aortic- and mitral-valve replacements sustained blunt chest trauma by falling 50 cm onto a metal wheelbarrow. Two hours later, he came to our hospital. On examination, the findings were identical to those at his last outpatient visit, except for fractures of the anterolateral left seventh and eighth ribs. Fourteen hours after the accident,
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