Management of Acute Upper Extremity Ischemia Attributed to Cardiac Abnormalities: 3 Cases
Journal Title: Scholars Journal of Medical Case Reports - Year 2018, Vol 6, Issue 9
Abstract
Ischemia of the upper extremity is a relatively infrequent problem facing the vascular surgeon. Patients usually present with a cool, pallid hand or evidence of distal gangrene. Claudication is unusual because of the abundant collateral arteries around the shoulder. When it occurs, arm ischemia may seriously jeopardize the livelihood and independence of the patient involved. Herein, we report three cases of upper extremity ischemia that all resulted of a cardiac aetiology, and we will consequently present a litterature revue of the global management of acute upper limb ischemia attricuted to a cardiac abnormality. Conclusion: Upper extremity ischemia related to cardiac abnormalities is frequently due to thromboembolism, most commonly from atrial fibrillation, which accounts for approximately 80% of upper extremity thromboembolism. Other less frequent causes include valvular abnormalities, cardiomyopathy, and atrial septal defects. In addition to treating the cardiac abnormality responsible for the embolism, these patients require systemic anticoagulation and often embolectomy. After embolectomy, patients must be monitored closely for development of compartment syndrome caused by reperfusion and treated accordingly.
Authors and Affiliations
O. Lamliki, H. EL Bhali, M. Chemlal, Y. Bahij
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