Rapidly developing massive thromboembolism and death due to anticoagulant dose reduction in a patient with atrial fibrillation: case Report

Abstract

Atrial fibrillation is one of the cardiac arrhythmias that can cause fatal complications. Patients diagnosed with atrial fibrillation face complications such as ischemic stroke, peripheral vascular embolism and pulmonary embolism if they are not under regular and strict treatment follow-up. In this case, in a 73-year-old woman with atrial fibrillation who was not receiving regular treatment, sudden onset of leg pain followed by rapid onset of dyspnea was clinically suggestive of acute peripheral arterial embolism followed by massive pulmonary embolism. The patient was tachypneic and confused at the time of presentation to the emergency department. After intubation with sedation and analgesia, radiologic imaging was obtained for possible complications secondary to atrial fibrillation. As a result, the patient had an embolus starting from the level of the abdominal aorta, extending to the right renal artery and spreading to the entire right iliac artery. The lung tissue showed bilateral acute lung injury without pulmonary embolism. In this case, we wanted to emphasize the importance of the subject by sharing the rapidly developing embolism and death process with the reduction of the anticoagulant dose used in the treatment of atrial fibrillation.