Left atrial septal pouch and acute thromboembolic ischemia of the upper limb

Abstract

Patient: Male, 60-year-old Final Diagnosis: Thromboembolic ischemia of the upper limb Symptoms: Pain and paresthesia in the right arm Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Background: Case Report: Conclusions: Rare coexistence of disease or pathology A left atrial septal pouch (LASP) was first described in 2010 as a new anatomical entity with potential for embolic events. The prevalences of left, right, and double septal pouches are 40.8%, 5.1%, and 3.7%, respectively. There is a concern about the risk of embolic events due to formation of thrombi in a LASP (especially stroke). A 60-year-old man presented with sudden onset of right arm pain associated with sweating and neck pain ra-diating to his left upper extremity. On physical examination, his right arm was cyanotic and he had pain, pares-thesia, and no radial pulse. The patient was diagnosed with acute arterial occlusion of his right upper extrem-ity. An arterial embolectomy was performed with a Fogarty catheter at the level of the brachial artery, which resulted in immediate reperfusion. The patient had an embolic event and after efforts to identify the possible etiology, only an LASP was found. Therefore, we hypothesized that he experienced an embolic event in which a thrombus had formed at the site of the LASP. The present case report is designed to raise awareness of the thrombogenic potential of LASP and the possi-bility of an embolic event to the upper limb of patients with it. LASP can be the source of a thrombus in a patient with a non-stroke embolic event.