Emergent pharmacological management of ulnar artery thrombosis

JEM reports Pub Date : 2023-06-01 DOI:10.1016/j.jemrpt.2023.100019

Henry Zou , Bethany Beard MD

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Abstract

Background

Ulnar artery thrombosis (UAT) refers to occlusion of the ulnar artery due to a blood clot and is a subcategory of hypothenar hammer syndrome (HHS). We present a case of right ulnar artery thrombosis that was pharmacologically managed in the Emergency Department (ED) and inpatient ward.

Case report

A 52-year-old male with a history of anemia and elevated ferritin presented to the ED with a 5-day history of skin discoloration, numbness, and tingling of his right 5th finger. CT angiogram showed a focal 1.5 cm-long thrombotic ulnar artery occlusion at the palmar bifurcation and embolic occlusion of the 5th digital arteries in the finger. Following consultation with vascular surgery, he was given intravenous heparin, transitioned to apixaban for lifelong anticoagulation therapy, and discharged following the placement of a Zio^Ⓡ patch.

Why should an emergency physician be aware of this?

The patient's career involving manual labor, elevated ferritin, and smoking history may have been risk factors for UAT development. Our case illustrates the value of interdisciplinary collaboration and conservative management in low-acuity cases of UAT.

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尺动脉血栓形成的紧急药物治疗

背景尺骨动脉血栓形成（UAT）是指由于血栓导致的尺骨动脉闭塞，是小鱼际锤综合征（HHS）的一个子类。我们报告了一例在急诊科（ED）和住院病房进行药物治疗的右尺动脉血栓形成病例。病例报告：一名52岁男性，有贫血和铁蛋白升高病史，向急诊科就诊，有5天的皮肤变色、麻木和右五指刺痛病史。CT血管造影显示手掌分叉处有1.5厘米长的局灶性血栓性尺动脉闭塞，手指第5指动脉栓塞闭塞。在咨询了血管手术后，他接受了静脉注射肝素，转为阿哌沙班进行终身抗凝治疗，并在放置ZioⓇ贴片后出院。为什么急诊医生应该意识到这一点？患者的体力劳动、铁蛋白升高和吸烟史可能是UAT发展的危险因素。我们的案例说明了跨学科合作和保守管理在UAT低敏锐度病例中的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JEM reports Emergency Medicine

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审稿时长

54 days