We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Akutni infarkt miokarda kao posljedica embolizacije u fibrilaciji atrija -- prikaz slučaja.
- Authors
Vujeva, Božo; Hadžibegović, Irzal; Prvulović, Đeiti; Gabaldo, Krešimir
- Abstract
INTRODUCTION: Atrial fibrillation is one of the most common arrhythmias and carries a great risk for cardioembolisation, with stroke and acute limb or mesenteric ischemia as one of the most severe consequences. Myocardial infarction is not commonly reported thromboembolic complication of atrial fibrillation. CASE REPORT: We present a case of a 73-year-old women who was first admitted in coronary care unit in General hospital Slavonski Brod because of non-ST-segment elevation myocardial infarction (NSTEMI). She was admited in sinus rhythm. She was treated with aspirin, clopidogrel and low-molecular-weight heparin (LMWH,) and scheduled for a coronary angiogram during the same hospital stay. On the third day of hospitalization, before planned coronarography, she developed a large retroperitoneal hematoma with no CT signs of active bleeding from any large vessel. She was treated conservatively with good recovery. During treatment several episodes of atrial fibrillation were documented. After introduction of amiodarone she was in stable sinus rhythm. After partial resolution of retroperitoneal heamatoma, coronary angiography was performed showing normal coronary arteries. She was discharged home in sinus rhytm, with aspirin, ACE inhibitor, beta-blocker, and statin. After 2 months she presented to emergency room with clinical signs of acute left arm ischemia. Color Doppler investigation showed signs of acute closure of left axillar artery. Basal ECG showed sinus rhytm. Urgent thrombendartherectomy with a Foley catheter was performed with prompt restoration of circulation. Early transesophageal echocardiography was performed showing a large thrombus in the left atrial appendage. Continuous ECG monitoring showed short episodes of atrial fibrillation and undulation. Along with LMWH, anticoagulation therapy with warfarin was introduced. CONCLUSIONS: Previous NSTEMI with normal coronary angiography and acute left arm ischemia were attributed to thromboembolisation from left atrial appendage. Optimal treatment strategies in this particular patients need to be discussed.
- Subjects
ATRIAL fibrillation treatment; MYOCARDIAL infarction treatment; CLOPIDOGREL
- Publication
Cardiologia Croatica, 2014, Vol 9, Issue 9/10, p350
- ISSN
1848-543X
- Publication type
Abstract