Prothrombin G20210A mutation in a 53-yearold male patient with deep vein thrombosis

Abstract

Patient: A 53-year-old man, ethnicity unknown. Chief Complaint: Leg swelling and pain. History of Present Illness: The patient has a history of atrial fibrillation that had been treated with 3 separate cardiac ablations, most recently in the year 2014. According to the patient, the symptoms had begun the day after his most recent cardiac ablation on June 27, 2014. The catheter for the procedure was inserted via the right femoral vein. The patient had returned to work, where he sits for an average of 8hours per day, but his pain became unbearable, so he went to the emergency department on July 3, 2014. Previous Medical History: In 2013, he was evaluated for a possible stroke. He reported consuming 1 to 2 alcoholic drinks per month, not using tobacco, and not being currently sexually active. He has no history of excessive bleeding or bruising. Previous Surgical History: The patient underwent an operation for an unruptured aneurysm in 2011; ablation for atrial fibrillation in 2006, 2009, and 2014; gastric bypass in 2006; left knee arthroscopy in 2010; and rotator cuff repair in 2013. Family History: The patient s sister had died of a pulmonary embolism (age at time of death unknown). His father had died of a stroke at age 49 years. His mother, who is still living, has a history of intracranial aneurysms. Physical Examination Results: The patient was alert and oriented; he cooperated with medical staff. His vital signs were normal, and all body systems were functioning normally. A large ecchymosis extended from his groin to his knee. Principal Laboratory Findings: See Tables 1-5.