Abstract
BackgroundIn this case report, we describe a very rare case of severe limb ischemia due to an arterial embolus caused by an aneurysm of the oval foramen in a term-born infant that occurred in the first few hours after birth.Case presentationA newborn male Caucasian patient presented on the maternity ward with ischemia of the right foot. Ischemia was treated with nitroglycerin spray and low-molecular-weight heparin in therapeutic dosage. An aneurysm of the oval foramen was found during postnatal echocardiography screening. This was thought to be the source of an embolus causing limb ischemia. At birth and upon follow-up, no clotting disorders were found. A large part of the right forefoot was ischemic, leading to loss of digits 1, 2, and 3. No significant loss of function was found in the first year of life.ConclusionSevere limb ischemia can be caused by an embolus arising from an aneurysm of the oval foramen and can be treated with heparin.
Highlights
In this case report, we describe a very rare case of severe limb ischemia due to an arterial embolus caused by an aneurysm of the oval foramen in a term-born infant that occurred in the first few hours after birth.Case presentation: A newborn male Caucasian patient presented on the maternity ward with ischemia of the right foot
Severe limb ischemia can be caused by an embolus arising from an aneurysm of the oval foramen and can be treated with heparin
Spontaneous acute limb ischemia is a rare problem in neonates, occurring in 2.4 out of every 1000 patients admitted to the neonatal intensive care unit (NICU) [1]
Summary
We describe a very rare case of severe limb ischemia due to an arterial embolus caused by an aneurysm of the oval foramen in a term-born infant that occurred in the first few hours after birth.Case presentation: A newborn male Caucasian patient presented on the maternity ward with ischemia of the right foot. Conclusion: Severe limb ischemia can be caused by an embolus arising from an aneurysm of the oval foramen and can be treated with heparin. The vast majority of cases (88%) of acute limb injury in neonates are secondary to iatrogenic injury due to arterial cannulation and subsequent thrombosis [2,3,4]. Clotting disorders or vascular malformations can be identified as causes, but there are only a few case reports of spontaneous ischemia without apparent cause [5].
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