The management of a patient with multiple infarcts with different etiologies

Andreea Elena Lăcraru,Andreea Catană,Cătălina Liliana Andrei,Crina Julieta Sinescu

doi:10.37897/rjmp.2021.3.16

Abstract

72 yo male, presents for abdominal pain and motor deficiency of the left upper limb. Clinical examination reveal severe general condition, left brachial hemiparesis, right arm blood pressure (BP) 240/120 mmHg, left arm BP 210/100 mmHg, heart rate (HR) 110 bpm, arrhythmic, abdominal pain at superficial palpation, without other abnormalities. Biological: negative hs troponin I, positive D-dimers, positive CRP, GFR 38 ml/min/m2, potassium 2.97 mmol/l. ECG: Atrial fibrillation. Abdominal ultrasound: abdominal dilated aorta, dissection flap. Abdominal and pelvic CT scan: right renal infarction, multiple splenic infarction, abdominal aortic aneurysm with dissection. Underwent interventional treatment of the abdominal aortic dissection (EVAR). Particularity of the case: concomitant diagnosis of multiple infarction with different etiologies, for which therapeutic decision was challenging.

Highlights

Case presentationsThe management of a patient with multiple infarcts with different etiologies Andreea Elena LĂCRARU1,2, Cătălina Liliana ANDREI1,2, Andreea CATANĂ1,2, Crina Julieta SINESCU1,2
The term of infarction refers to the occurrence of prolonged ischemia in a certain organ as a result of the inadequate blood supply to the affected area
It may have different etiologies, like an obstruction in the vessel due to atherosclerotic plaque, arterial embolus or thrombus; ruptured of the vessel causing a loss of blood pressure downstream of the rupture; vasoconstriction of the vessel or compressed by something

Summary

Case presentations

The management of a patient with multiple infarcts with different etiologies Andreea Elena LĂCRARU1,2, Cătălina Liliana ANDREI1,2, Andreea CATANĂ1,2, Crina Julieta SINESCU1,2. 1 “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania 2 “Bagdasar-Arseni“ Emergency Clinical Hospital, Bucharest, Romania

INTRODUCTION

CASE PRESENTATION

Findings

CONCLUSIONS