An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm

Renal artery embolism (RAE) is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF), and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describ...

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Main Authors: Ashok Kumar, Aditya Kapoor, Sudeep Kumar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Saudi Journal of Kidney Diseases and Transplantation
Online Access:http://www.sjkdt.org/article.asp?issn=1319-2442;year=2016;volume=27;issue=2;spage=398;epage=401;aulast=Kumar
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author Ashok Kumar
Aditya Kapoor
Sudeep Kumar
author_facet Ashok Kumar
Aditya Kapoor
Sudeep Kumar
author_sort Ashok Kumar
collection DOAJ
description Renal artery embolism (RAE) is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF), and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describe an unusual case of a young female who presented with sudden onset right flank pain, vomiting, anorexia, and hematuria, and was found to have thrombotic occlusion of the distal right renal artery. Although she denied any previous cardiac history, detailed cardiovascular examination revealed the presence of severe rheumatic mitral stenosis without any evidence of AF or left atrial clot. She was initially managed conservatively using low molecular weight heparin followed by oral anticoagulation with resolution of symptoms. A successful balloon mitral valvotomy was performed six weeks later. The patient is asymptomatic at her last follow-up of six months with preserved renal function. In symptomatic patients, clinicians need to consider the possibility of RAE even in patients of valvular heart disease with underlying sinus rhythm. Appropriate management of the underlying cardiac condition is imperative since embolism may be recurrent leading to compromise of renal function, if left untreated.
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spelling doaj.art-6b20557ea1954fc9a019483758ed497b2022-12-21T17:13:12ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422016-01-0127239840110.4103/1319-2442.178580An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythmAshok KumarAditya KapoorSudeep KumarRenal artery embolism (RAE) is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF), and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describe an unusual case of a young female who presented with sudden onset right flank pain, vomiting, anorexia, and hematuria, and was found to have thrombotic occlusion of the distal right renal artery. Although she denied any previous cardiac history, detailed cardiovascular examination revealed the presence of severe rheumatic mitral stenosis without any evidence of AF or left atrial clot. She was initially managed conservatively using low molecular weight heparin followed by oral anticoagulation with resolution of symptoms. A successful balloon mitral valvotomy was performed six weeks later. The patient is asymptomatic at her last follow-up of six months with preserved renal function. In symptomatic patients, clinicians need to consider the possibility of RAE even in patients of valvular heart disease with underlying sinus rhythm. Appropriate management of the underlying cardiac condition is imperative since embolism may be recurrent leading to compromise of renal function, if left untreated.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2016;volume=27;issue=2;spage=398;epage=401;aulast=Kumar
spellingShingle Ashok Kumar
Aditya Kapoor
Sudeep Kumar
An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm
Saudi Journal of Kidney Diseases and Transplantation
title An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm
title_full An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm
title_fullStr An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm
title_full_unstemmed An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm
title_short An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm
title_sort unusual case of hematuria in a young female renal artery embolism mitral stenosis and sinus rhythm
url http://www.sjkdt.org/article.asp?issn=1319-2442;year=2016;volume=27;issue=2;spage=398;epage=401;aulast=Kumar
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