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Yeungnam Univ J Med > Volume 34(2); 2017 > Article
Yeungnam University Journal of Medicine 2017;34(2):242-246.
DOI: https://doi.org/10.12701/yujm.2017.34.2.242    Published online December 31, 2017.
Acute upper limb ischemia in a patient with newly diagnosed paroxysmal atrial fibrillation
Dong Shin Kim, Seunghwan Kim, Hyang Ki Min, Chiwoo Song, Young Bin Kim, Sae Jong Kim, Ji Young Park, Sung Kee Ryu, Jae Woong Choi
Department of Cardiology, Seoul Eulji Hospital, Eulji University College of Medicine, Seoul, Korea. cloudksh@gmail.com
Abstract
Acute limb ischemia (ALI) due to an embolism is associated with high mortality rate and poor prognosis, and early diagnosis with prompt revascularization is required to reduce the risk of limb amputation or even death. The etiologies of ALI are diverse, and it includes an embolism from the heart and thrombotic occlusion of the atherosclerotic native vessels, stents, or grafts. An uncommon cause of ALI is acute arterial thromboembolism, and atrial fibrillation (AF) is the single most important risk factors for systemic thromboembolism. It is important to correctly identify the source of ALI for secondary prevention, as it depends on the underlying cause. Percutaneous transluminal angioplasty (PTA) has been proven to be a safe and effective treatment for focal atherosclerotic and thrombotic occlusive diseases of the aorta and its major extremity branches. Herein, we report on a 77-year-old female patient with acute upper limb ischemia, treated by PTA using a catheter-guided thrombectomy. He was newly diagnosed with paroxysmal AF (PAF) while evaluation the cause of his acute arterial thromboembolism. We recommend that cardiologists always consider PAF as a possible diagnosis even in patients without any history of AF under ALI because it is possible to develop thromboembolism in clinical practice.
Key Words: Thromboembolism, Atrial fibrillation, Peripheral arterial disease, Angioplasty


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