Acute Kidney Infarction Secondary to Intracardiac Thrombus Embolization in a Patient with Ischemic Dilated Cardiomyopathy

Abstract

Acute renal infarction due to emboli represents a very rare but significant threat for kidney loss, and the clinical presentation is challenging. The differential diagnosis of massive renal thrombi includes all other causes of abdominal pain, and they can be easily misdiagnosed as renal colic due to nephrolithiasis. Although there are a few case reports regarding the possibility that cardiac emboli may cause acute kidney infarction, intracardiac thrombi within the ventricular cavity diagnosed by echocardiography as a cause of such renal artery occlusion have never been reported in patients with cardiomyopathy. Herein, we describe a 39-year-old male with a history of ischemic dilated cardiomyopathy. He was admitted to our hospital with left upper abdominal pain and vomiting. After serial examinations and tests, the diagnosis of acute renal infarction due to intracardiac thrombus embolization as a result of severely reduced cardiac function was made.

Use of point‐of‐care ultrasound to diagnose an alternate cause of flank pain in a patient with presumed renal colic

“…10,11 Additionally, a medical history of dilated cardiomyopathy, recurrent myocardial infarction, and atrial fibrillation are potential causes of ventricular thrombus. 12,13 However, the majority of intracardiac thrombus cases are detected incidentally during routine ECHO, which is part of the workup for other diseases, such as cerebrovascular accident and acute coronary syndrome. 14 Furthermore, cardiac emboli have been found in the lungs, kidneys, spleen, intestines, brain, and extremities.…”

Infarto renal bilateral por fibrilación auricular crónica

“…La elevación de LDH es el hallazgo analítico, más sensible y se encuentra en casi el 100 % de los casos, aunque es bastante inespecífico, los valores del DHL comienzan a elevarse en las primeras 12 a 24 horas y pueden permanecer elevadas después de dos semanas. 8,9 La sospecha clínica de neoplasia renal fue descartada con el estudio tomográfico contrastado, observándose imágenes hipodensas en ambos riñones, en forma de cuña, con límites netos y rectilíneos sugerentes de infarto reciente que no captan el contraste. (Figuras 1 y 2).…”

Reccurent thrombus in the gigantic left atrium during effective anticoagulant therapy: case report

“…Gigantic LA is linked to the occurrence and persistence of atrial fibrillation (AF), but also to the development of a thrombus in the LA. Taken together, this significantly increases the risk of thrombotic eventssuch as stroke, acute limb ischemia or rarely even kidney infarctions [4]. In the case of stroke, AF is known to cause up to 20% of all ischemic strokes and thus proper rate control and especially anticoagulation therapy are necessary to help prevent thrombotic events [5].…”