A 58-year-old man with a history of atrial fibrillation not on anticoagulation presents with acute left leg pain, coolness, and pallor. Vital signs show HR 118 bpm, BP 142/88 mmHg, RR 20, temp 37.2°C. Physical exam reveals absent left femoral pulse and mottled skin; right leg pulses remain intact. ECG confirms atrial fibrillation with rapid ventricular response. Doppler ultrasound shows no atherosclerotic plaque in the aorta. Which of the following is the most likely source of embolism?
- A)Left atrial thrombus from atrial fibrillationGABARITO
- B)Venous thrombosis from prolonged immobility
- C)Ruptured atherosclerotic plaque in the aorta
- D)Left ventricular thrombus from prior myocardial infarction
- E)Paradoxical embolism through a patent foramen ovale
Explicação
Acute limb ischemia in an untreated atrial fibrillation patient is caused by arterial embolism from a left atrial thrombus. Atrial fibrillation causes blood stasis, promoting thrombosis in the left atrial appendage, which frequently embolizes systemically. Ver explicação completa e trilha adaptativa →