Document Detail

Paradoxical arterial emboli causing acute limb ischemia in a patient with essential thrombocytosis.
MedLine Citation:
PMID:  14501234     Owner:  NLM     Status:  MEDLINE    
Acute arterial occlusion can be the result of acute thrombosis or systemic embolism. Paradoxical embolism of a venous thrombosis through a right-to-left shunt is an important cause of acute limb ischemia. We describe a young patient with acute limb ischemia who was found to have multiple deep venous thromboses causing arterial embolization through a patent foramen ovale. Essential thrombocytosis was found to be the risk factor for venous thromboses in this patient. The patient was managed with embolectomy and anticoagulation along with chemotherapeutic cytoreduction of platelet count. This case illustrates the importance of considering the systemic embolism as a cause of acute arterial occlusion. The presence of a hypercoagulable status such as chronic myeloproliferative disorder does not eliminate the possibility of systemic embolism in the event of acute arterial occlusion. Patients presenting with acute limb ischemia should be evaluated for embolic sources. The presence of deep venous thrombosis in such a patient should prompt the evaluation for a patent foramen ovale.
Shahid Ahmed; Adnan Sadiq; Anita K Siddiqui; Elliot Borgen; Joseph Mattana
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  326     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-22     Completed Date:  2003-10-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  156-8     Citation Subset:  AIM; IM    
Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA.
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MeSH Terms
Arterial Occlusive Diseases / pathology*
Embolism, Paradoxical / pathology*
Heart Septal Defects, Atrial / pathology
Risk Factors
Thrombocytosis / pathology*
Venous Thrombosis / diagnosis*,  pathology

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