title: A Case Of Acute Thromboembolic Renal Infarction Associated with Paroxysmal Atrial Fibrillation.
abstract: Infarction of the kidney is an uncommon condition that can result from obstruction or decrease of renal arterial flow. The diagnosis is often delayed because it can mimic many other pathologic states, including pyelonephritis, renal colic, acute abdomen, pancreatitis and more. A high index of suspicion is important for prompt diagnosis. We describe a 20-year-old man presented with abdominal and right flank pain and hematuria. A computed tomography scan with intravenous contrast showed partial infarction of right renal parenchyma and selective renal angiography showed complete occlusion of the right renal artery which was also supplied by an accessory renal artery. Electrocardiography showed normal sinus rhythm. Transthoracic and transesophageal echocardiographic findings were unremarkable except for mild spontaneous echo contrast (SEC) in the left atrial appendage. Subsequent 48-hour holter monitor revealed frequent premature atrial complexes and paroxysmal atrial fibrillation (PAF). Development of thromboembolic renal infarction was attributed to the presence of PAF and concurrent SEC in the left atrial appendage (LAA). Low molecular weight heparin(LMWH) was followed by oral anticoagulant and an electrophysiologic study was planned for the management of PAF after 4 weeks of anticoagulation.
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Macit
authors.initials: M
authors.lastname: Kalcik
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yesin
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Lutfi
authors.initials: L
authors.lastname: Ocal
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Akgun
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Nursen
authors.initials: N
authors.lastname: Keles
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Mustafa Ozan
authors.initials: MO
authors.lastname: Gursoy
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey; Kars Kafkas University Faculty of Medicine, Department of Cardiology, Kars, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozkan
keywords: Paroxysmal Atrial Fibrillation; Renal Infarction; Thromboembolism