famous is coumadin now we have four new prescription medicines that have some advantages over coumadin as more potent blood thinners and if you have to give it intravenously then its medicines called heparin okay so how are we going to choose what we need to do is the patient comes in and we need to sort out why they had the stroke sometimes there's rare causes that we don't have time to talk about tonight but most of the time you're going to find out that the guilty party is atherosclerosis or it's a problem at the heart or as I said