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World Heart Congress

Osaka, Japan

Richultz C. Montevirgen

World Citi Medical Center, Philippines

Title: TIME IS LIMB: A case report of acute limb ischemia of the upper extremity

Biography

Biography: Richultz C. Montevirgen

Abstract

Acute limb ischemia of the upper extremity is the non-traumatic acute occlusion of arterial supply to a limb or organ presented with a constellation of symptoms specific to the tissue suddenly deprived of arterial perfusion. Irrespective of the arterial segment involved, this syndrome represents a vascular emergency. In every day clinical practice, acute arterial occlusion is synonymous with acute limb ischemia. Rapid recognition and treatment are required to prevent limb loss and life-threatening morbidity. Management of the syndrome has evolved, but the diagnostic skills required to recognize this clinical entity remain unchanged. We are presented with a case of a 65 year old, male, Filipino, who came in due to sudden right hand pain. The patient was presented initially with right hand pain that eventually developed numbness accompanied by pulselessness and cyanosis. The patient was then referred to a TCVS specialist for co-management, portable Doppler confirmed the absence of pulses in the radial and ulnar regions of the right hand. Anticoagulation using heparin bolus followed by heparin drip was initiated; the patient was then scheduled for emergency embolectomy. Intraoperative findings confirmed the presence of obstructing emboli in both radial and ulnar arteries of the right hand, freeing the obstruction resulted in immediate reperfusion of the affected limb. Post operatively, prothrombin and partial thromboplastin time was monitored. Warfarin 5 mg/tab was overlapped with the heparin drip while continuously monitoring the coagulation parameters for anticoagulant adjustments. This case highlights the importance of early recognition and emergent treatment of acute limb ischemia, which includes the paramount importance of proper history taking and physical examination, high index of suspicion, and non-invasive diagnostic tests that could give a quick but reliable impression to guide in the proper care of these kinds of patients are recommended. Prompt initiation of anticoagulation is the first line of treatment while embolectomy provides cure.

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