Acute renal infarction from a cardiac thrombus.
BACKGROUND
A 53-year-old man presented to hospital 2 hours after the abrupt onset of left upper abdominal pain. He was treated with analgesics and discharged after 4 hours of observation, but presented to another hospital 2 hours later with severe left abdominal pain. His past medical history included ischemic dilated cardiomyopathy due to recurrent myocardial infarction.


METHODS
Physical examination, electrocardiography, laboratory investigations, contrast-enhanced computed tomography, and transesophageal echocardiography.


METHODS
Renal artery thromboembolism resulting from dilated cardiomyopathy, severely reduced cardiac function and an intracardiac thrombus.


RESULTS
Anticoagulation with unfractionated heparin followed by enoxaparin and warfarin.
Nasser
Nicola J
NJ
Department of Internal Medicine B, Rambam Health Care Campus, Haifa 31096, Israel. nicola.nasser@gmail.com
Abadi
Sobhi
S
Azzam
Zaher S
ZS
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000925:Anticoagulants / Q000008:administration & dosage; D002311:Cardiomyopathy, Dilated / Q000150:complications; D003328:Coronary Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D017984:Enoxaparin / Q000008:administration & dosage; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D017984:Enoxaparin; D014859:Warfarin