International Journal of Case Reports and Images - IJCRI - Case Reports, Case Series, Case in Images, Clinical Images

     
Case Report
 
Peripheral emboli in a patient with atrial fibrillation: A case report
Ismail Tabash1, Alexa S. Riester2, Rebecca Napier1, Joe B. Calkins3
1MD, Cardiology Section, Augusta University, 15th Street Augusta, GA
2MD, Emergency Medicine Department, Augusta University, 15th Street Augusta, GA
3MD, F.A.C.C., Street Augusta, GA

Article ID: Z01201710CR10840IT
doi:10.5348/ijcri-2017101-CR-10840

Address correspondence to:
Ismail Tabash
MD, Cardiology Section, Augusta University
1120 15th Street Augusta
GA 30912

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How to cite this article
Tabash I, Riester AS, Napier R, Calkins JB. Peripheral emboli in a patient with atrial fibrillation: A case report. Int J Case Rep Images 2017;8(10):653–658.


ABSTRACT

Introduction: Atrial fibrillation is a common arrhythmia that can be associated with a high risk of thromboembolic complications. Ischemic stroke due to involvement of the cerebrovascular circulation is the most common of these complications. Peripheral emboli may not be as easily recognized and the data regarding their risk, incidence and diagnosis is limited.
Case Report: A 46-year-old female presented with exertional dyspnea and right leg pain. Her rhythm was atrial fibrillation. Echocardiogram showed a large left atrial mass and computed tomography angiogram demonstrated filling defects in the left atrium and in the superior mesenteric artery. A peripheral angiogram showed occlusion of the right popliteal artery. The patient underwent right popliteal arterial thrombectomy and excision of the left atrial mass, which was found to be an organized thrombus. Anticoagulation was initiated and continued after discharge.
Conclusion: Peripheral emboli may account for 10–20% of embolic events related to atrial fibrillation. They are associated with significant morbidity and mortality and may often go unrecognized unless a high index of clinical suspicion is present. These patients are at high risk for recurrent peripheral embolic events and for future thromboembolic stroke. Lifelong anticoagulation is required. The literature concerning the incidence, risk, diagnosis, management and prognosis of peripheral arterial emboli in atrial fibrillation is reviewed.

Keywords: Arterial, Atrial fibrillation, Peripheral, Thromboembolism



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Author Contributions
Ismail Tabash – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alexa S. Riester – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Rebecca Napier – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Joe B. Calkins – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guarantor
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Ismail Tabash et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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