Case History/examination:
A 74-year-old female with a past medical history of atrial fibrillation on rivaroxaban with questionable compliance, type 2 diabetes, multiple cerebrovascular accidents, and suspected paranoid schizophrenia, was brought to the ED with altered mental status.
On examination, her pulse was 114/min, irregularly irregular, blood pressure of 123/109 mmHg, respiratory rate of 24/min, afebrile, and was maintaining oxygen saturation of 95% at room air.