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BMJ Case Reports 2017; doi:10.1136/bcr-2017-222748
  • Images in…

Giant atrium, giant clot: need for anticoagulation

  1. Anupam A Sule1
  1. 1Internal Medicine, Saint Joseph Mercy Oakland, Pontiac, Michigan, USA
  2. 2Cardiology, Saint Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
  1. Correspondence to Dr Murad Abdelsalam, Murad.abdelsalam{at}gmail.com
  • Accepted 25 October 2017
  • Published 9 November 2017

Description

We present a patient with medical history of atrial fibrillation, rheumatic mitral valve stenosis and ulcerative colitis who came to the emergency room with onset of bilateral lower extremity pain 2 hours prior to presentation. On examination, feet were pale, cold and pulses were absent. Patient used to be on warfarin for atrial fibrillation which was discontinued 1 month ago by his primary care physician due to recurrent bleeding. Atrial fibrillation with controlled ventricular response was seen on ECG. Emergent arterial Doppler revealed occlusion of the bilateral calf arteries at the level of …

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