A case report of acute Leriche syndrome: aortoiliac occlusive disease due to embolization from left ventricular thrombus caused by myocarditis

Abstract

Background Leriche syndrome is the triad of symptoms consisting of claudication, erectile dysfunction, and absence of femoral pulses. Inflammatory disease of the heart muscle, myocarditis, may occur because of immune system activation, drug exposure or infections. Case presentation A 31-year-old man with no previous medical history presented to the emergency department with acute back pain that had started suddenly during weightlifting, which was initially misdiagnosed as spinal disc herniation. The patient returned four hours later and a thoracoabdominal computed tomography showed a large thrombus in the aortoiliac region creating a total occlusion. Vascular surgery with embolectomy was immediately performed. Further investigation with echocardiography revealed deteriorated systolic dysfunction with marked hypokinesia and two large thrombi in the left ventricle. Cardiac magnetic resonance imaging showed late contrast enhancement of the inferolateral and septal regions, which indicated a recent myocarditis. Conclusion Myocarditis can result in multiple embolization with diverse organ manifestation including total occlusion of the aortoiliac arteries, which required urgent embolectomy.

Leriche syndrome: Clinical and diagnostic approach of a rare infrarenal aortoiliac occlusive disease

“…While Leriche syndrome is typically a chronic atherosclerotic disease, however, acute cases have also been reported [16 , 17] . Concomitant acute pulmonary embolism and acute myocardial infarction associated were evident in a patient with Leriche syndrome [18] .…”

Antiphospholipid Syndrome-Induced Leriche Syndrome in a Man with Lower Limbs Sensory and Motor Defect

“…Leriche syndrome was originally described as the syndrome of thrombotic obliteration of the aortic bifurcation and is more commonly observed in men in the third to sixth decades of life [ 10 , 11 ]. The typical presentation occurs in male patients with the clinical triad of intermittent claudication, impotency, and absent femoral pulses [ 12 ]. However, co-occurrence of Leriche syndrome and antiphospholipid syndrome may present with vary atypical symptoms, such as chronic ulcers, musculoskeletal events, pulmonary diseases, optic neuropathy, and adrenal insufficiency.…”

EVC isquémico embólico en arteria cerebral media secundaria a síndrome de Leriche tipo 1, a propósito de un caso

“…Se define como oclusión de las ramas principales de la aorta abdominal de localización infrarrenal, que compromete a las arterias ilíacas, femorales y tibiales de ambos miembros pélvicos inferiores 3 . Los factores de riesgo incluyen hiperlipidemia, hipertensión, sexo masculino, enfermedades autoinmunes y tabaquismo 4,5 .…”