A 72-year-old man with chronic atrial fibrillation not on anticoagulation presents with acute left lower extremity pain and coolness. Vital signs show HR 102 and irregular, BP 138/85, RR 16, SpO2 98%. Physical exam reveals mottled skin and absent left femoral pulses. Labs show elevated D-dimer at 2.8 μg/mL. Doppler ultrasound confirms acute arterial occlusion of the left superficial femoral artery. Cardiac auscultation reveals no new murmurs. Which of the following is the most likely source of this embolus?
- A)Left atrial thrombus from atrial fibrillationGABARITO
- B)Paradoxical embolus via PFO
- C)Arterial aneurysm with mural thrombus
- D)In situ thrombosis from hypercoagulability
- E)Atherosclerotic plaque rupture
Explicação
Atrial fibrillation causes blood stasis in the left atrial appendage, predisposing to thrombus formation. Unticoagulated AF patients have high embolic risk. Acute arterial occlusion from cardioemboli typically affects the femoral bifurcation and causes acute l... Ver explicação completa e trilha adaptativa →