ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics.

eISSN: 2980-1400
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Rapidly developing massive thromboembolism and death due to anticoagulant dose reduction in a patient with atrial fibrillation: case Report
Abstract
Atrial fibrillation is one of the cardiac arrhythmias that can cause fatal complications. Patients diagnosed with atrial fibrillation face complications such as ischemic stroke, peripheral vascular embolism and pulmonary embolism if they are not under regular and strict treatment follow-up. In this case, in a 73-year-old woman with atrial fibrillation who was not receiving regular treatment, sudden onset of leg pain followed by rapid onset of dyspnea was clinically suggestive of acute peripheral arterial embolism followed by massive pulmonary embolism. The patient was tachypneic and confused at the time of presentation to the emergency department. After intubation with sedation and analgesia, radiologic imaging was obtained for possible complications secondary to atrial fibrillation. As a result, the patient had an embolus starting from the level of the abdominal aorta, extending to the right renal artery and spreading to the entire right iliac artery. The lung tissue showed bilateral acute lung injury without pulmonary embolism. In this case, we wanted to emphasize the importance of the subject by sharing the rapidly developing embolism and death process with the reduction of the anticoagulant dose used in the treatment of atrial fibrillation.

Keywords : Warfarin, embolism and thrombosis, atrial fibrillation

Download Article


1. Hindricks G. Potpara T. Dagres N. et al. 2020 ESC Guidelines forthe diagnosis and management of atrial fibrillation developed incollaboration with the European Association for Cardio¬ThoracicSurgery (EACTS). Eur Heart J. 2021;42(5):373-498.
2. Albertsen IE, Rasmussen LH, Overvad TF, Graungaard T, LarsenTB, Lip GY. Risk of stroke or systemic embolism in atrial fibrillationpatients treated with warfarin: a systematic review and meta-analysis.Stroke. 2013; 44(5):1329-1336.
3. Katırcıoglu EG, Yalcın M, Unlu Y. Akut periferik arteryel embolivakalarinda girişim zamanlamasının müdahale sonuçları üzerineetkisi. Atatürk Üniversitesi Tıp Fakültesi Cerrahi Tıp Bilimleri Dergisi.2023; 2(1): 5-12.
4. Haimovici H, Ascer E, Hollier L.H. Arterial embolism of the extremitiesand technique of embolectomy. In: H. Haimovici ed. Vasculer Surgery.Cambridge Masachusets Blackwell Science, Fourth edition 1996; 423-444.
5. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence,incidence, and predictors of atrial fibrillation in the Renfrew/Paisleystudy. Heart 2001; 86: 516-521.
6. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrialfibrillation in adults: national implications for rhythm managementand stroke prevention: the AnTicoagulation and Risk Factors in AtrialFibrillation (ATRIA) Study. JAMA 2001; 285: 2370-2375.
7. Karaçağlar E, Atar İ, Yetiş B. ve ark. Atriyal fibrilasyon hastalarındaemboli risk faktörleri sıklığı ve emboli önleyici tedavilerinuygunluğunun araştırılması: Tek üçüncül bir merkez deneyimiAnadolu Kardiyoloji Dergisi 2012; 12(5) : 384-390.
8. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrialfibrillation. Ann Intern Med 2007; 146: 857-867.
9. Coutrot M, Delrue M, Joly BS, Siguret V. Unexpected acute pulmonaryembolism in an old COVID-19 patient with warfarin overdose: a casereport. Eur Heart J Case Rep. 2021; 5(6):206.
10. Aysel S, Ramazan E, Ahmet A. Massive Pulmonary Embolism in aPatient Using Warfarin at Therapeutic Dose. J Clin Diagn Res. 2016;10(9): 9-10.
Article available in :
Volume 1, Issue 4, 2023
Page : 98-100
https://doi.org/10.51271/ICJEM-0025
Article Information
Received : 15 Ara 2023
Accepted : 28 Ara 2023
Published : 30 Ara 2023
Corresponding Author :

Necmi Baykan: Department of Emergency Medicine, Kayseri City Hospital, Kayseri, Turkiye

[email protected]
Citation : İpek ÖF, Alpaslan M, Eşliku M, Çakmak Coşkun T, Baykan N. Rapidly developing massive thromboembolism and death due to anticoagulant dose reduction in a patient with atrial fibrillation: case Report. Intercont J Emerg Med. 2023;1(4):99-101.

Read: 319
Download : 365
Cited: 0
_Footer