A 71-year-old man with untreated chronic atrial fibrillation presents with sudden-onset severe left leg pain and numbness. Vital signs: BP 138/82 mmHg, HR 112 bpm and irregular, RR 18, SpO2 98% on room air. Physical examination reveals a pale, cool left leg with absent dorsalis pedis and posterior tibial pulses. Serum creatinine is 1.1 mg/dL. No prior claudication history. Which of the following is the most likely cause?
- A)Atherosclerotic claudication due to chronic plaque buildup
- B)Popliteal cyst rupture
- C)Chronic venous insufficiency
- D)Arterial embolism to the lower extremityGABARITO
- E)Cellulitis due to skin flora
Explicação
Sudden painful pulseless pallid limb in a patient with atrial fibrillation is classic for acute arterial embolism, often originating from left atrial thrombus. Acute limb ischemia presents with the six Ps: pain, pallor, pulselessness, paresthesias, paralysis, ... Ver explicação completa e trilha adaptativa →