A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report
Abstract Background Atrial fibrillation is one of the most common arrhythmias. The main thrombotic complication of arterial fibrillation is ischemic stroke, but it can also cause acute renal infarction from embolization. The low incidence and nonspecific clinical manifestations of acute renal infarc...
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-022-03608-z |
| _version_ | 1811336490423156736 |
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| author | Tao Ge ZhengCai Zhu Jinfeng Wang Wenjiao Zhou Evelyn J. Song Shengxing Tang |
| author_facet | Tao Ge ZhengCai Zhu Jinfeng Wang Wenjiao Zhou Evelyn J. Song Shengxing Tang |
| author_sort | Tao Ge |
| collection | DOAJ |
| description | Abstract Background Atrial fibrillation is one of the most common arrhythmias. The main thrombotic complication of arterial fibrillation is ischemic stroke, but it can also cause acute renal infarction from embolization. The low incidence and nonspecific clinical manifestations of acute renal infarction make it difficult to diagnose, often leading to either delayed diagnosis or misdiagnosis. Due to its rarity, more efficient treatment guidelines are helpful for the management of acute renal infarction related to the thromboembolic complication of arterial fibrillation. Case reports We report a case of acute renal infarction due to underlying arterial fibrillation, where a novel interventional therapeutic method was used. A 66-year-old Chinese man with arterial fibrillation, not on anticoagulation due to the patient’s preference, and coronary artery disease post-percutaneous coronary intervention to left anterior descending artery about 1 year ago, was currently on dual antiplatelet therapy. He suddenly developed intermittent and sharp left-sided abdominal pain and was found to have an acute left renal infarction on computed tomography scan. Angiogram showed acute occlusion of the left renal artery due to thromboembolism. For this patient, a combination method of local thrombus aspiration, angioplasty, and infusion of nitroglycerin and diltiazem were used, restoring blood flow to the left kidney. After recovery, the patient was discharged on aspirin, clopidogrel, and warfarin. At 6 months follow-up, there was no residual kidney dysfunction. Conclusions Acute renal infarction from thromboembolism is a rare but serious complication of arterial fibrillation. More efficient and different options for intervention methods will benefit the treatment of this disease. Here, we report a combination therapeutic method that has not been used in acute renal infarction associated with arterial fibrillation, and which restored renal perfusion and prevented long-term kidney injury. |
| first_indexed | 2024-04-13T17:40:17Z |
| format | Article |
| id | doaj.art-0d7bd125fcdf467f8db0d262fe76b1b7 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T17:40:17Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-0d7bd125fcdf467f8db0d262fe76b1b72022-12-22T02:37:11ZengBMCJournal of Medical Case Reports1752-19472022-10-011611610.1186/s13256-022-03608-zA rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case reportTao Ge0ZhengCai Zhu1Jinfeng Wang2Wenjiao Zhou3Evelyn J. Song4Shengxing Tang5Department of Cardiology, The First Affiliated Hospital, Wannan Medical CollegeDepartment of Cardiology, The First Affiliated Hospital, Wannan Medical CollegeDepartment of Cardiology, The First Affiliated Hospital, Wannan Medical CollegeDepartment of Electrocardiogram, The First Affiliated Hospital, Wannan Medical CollegeDivision of Cardiology, University of California San FranciscoDepartment of Cardiology, The First Affiliated Hospital, Wannan Medical CollegeAbstract Background Atrial fibrillation is one of the most common arrhythmias. The main thrombotic complication of arterial fibrillation is ischemic stroke, but it can also cause acute renal infarction from embolization. The low incidence and nonspecific clinical manifestations of acute renal infarction make it difficult to diagnose, often leading to either delayed diagnosis or misdiagnosis. Due to its rarity, more efficient treatment guidelines are helpful for the management of acute renal infarction related to the thromboembolic complication of arterial fibrillation. Case reports We report a case of acute renal infarction due to underlying arterial fibrillation, where a novel interventional therapeutic method was used. A 66-year-old Chinese man with arterial fibrillation, not on anticoagulation due to the patient’s preference, and coronary artery disease post-percutaneous coronary intervention to left anterior descending artery about 1 year ago, was currently on dual antiplatelet therapy. He suddenly developed intermittent and sharp left-sided abdominal pain and was found to have an acute left renal infarction on computed tomography scan. Angiogram showed acute occlusion of the left renal artery due to thromboembolism. For this patient, a combination method of local thrombus aspiration, angioplasty, and infusion of nitroglycerin and diltiazem were used, restoring blood flow to the left kidney. After recovery, the patient was discharged on aspirin, clopidogrel, and warfarin. At 6 months follow-up, there was no residual kidney dysfunction. Conclusions Acute renal infarction from thromboembolism is a rare but serious complication of arterial fibrillation. More efficient and different options for intervention methods will benefit the treatment of this disease. Here, we report a combination therapeutic method that has not been used in acute renal infarction associated with arterial fibrillation, and which restored renal perfusion and prevented long-term kidney injury.https://doi.org/10.1186/s13256-022-03608-zAcute renal infarctionInterventional therapyAtrial fibrillationAbdominal pain |
| spellingShingle | Tao Ge ZhengCai Zhu Jinfeng Wang Wenjiao Zhou Evelyn J. Song Shengxing Tang A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report Journal of Medical Case Reports Acute renal infarction Interventional therapy Atrial fibrillation Abdominal pain |
| title | A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report |
| title_full | A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report |
| title_fullStr | A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report |
| title_full_unstemmed | A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report |
| title_short | A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report |
| title_sort | rare cause of abdominal pain managed unconventionally acute renal infarction caused by atrial fibrillation a case report |
| topic | Acute renal infarction Interventional therapy Atrial fibrillation Abdominal pain |
| url | https://doi.org/10.1186/s13256-022-03608-z |
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