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Acute renal infarction from a cardiac thrombus

  • Case Study
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From Nature Clinical Practice Nephrology

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Abstract

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.

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

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

Management Anticoagulation with unfractionated heparin followed by enoxaparin and warfarin.

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Figure 1: Axial contrast-enhanced computed tomography image of the patient's abdomen with maximal intensity projection reconstruction.
Figure 2: Transesophageal echocardiogram showing the severely enlarged left atrium and ventricle.
Figure 3: Contrast-enhanced computed tomography images of the patient's abdomen on his second admission to hospital, with maximal intensity projection reconstruction.

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Authors and Affiliations

  1. NJ Nasser is a Resident in Oncology in the Department of Internal Medicine B at Rambam Health Care Campus, S Abadi is a Staff Radiologist in the Department of Diagnostic Imaging at the Rambam Health Care Campus, and ZS Azzam is a Specialist in Internal Medicine and Cardiology and the Acting Director of the Department of Internal Medicine B at Rambam Health Care Campus, Haifa, Israel.,

    Nicola J Nasser, Sobhi Abadi & Zaher S Azzam

Authors
  1. Nicola J Nasser
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  2. Sobhi Abadi
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  3. Zaher S Azzam
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Correspondence to Nicola J Nasser.

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The authors declare no competing financial interests.

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Nasser, N., Abadi, S. & Azzam, Z. Acute renal infarction from a cardiac thrombus. Nat Rev Nephrol 3, 631–635 (2007). https://doi.org/10.1038/ncpneph0624

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  • DOI: https://doi.org/10.1038/ncpneph0624

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