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[Inferior vena cava obstruction in patient with coronary artery disease]

Józefa Dabek1, Daniel Jakubowski, Andrzej Kułach

  • 1Katedra i Klinika Kardiologii Slaskiego Uniwersytetu Medycznego w Katowicach. jdabek@sum.edu.pl

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|March 17, 2010
PubMed

Insights

This case study highlights a 76-year-old male with multiple cardiovascular pathologies, including coronary artery stenosis and venous obstructions. Comprehensive diagnostics and tailored antithrombotic therapy were crucial for managing his complex thromboembolic disease.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Nephrology

Background:

  • The patient presented with chest pain and syncope, with a history of myocardial infarction and nephrectomy.
  • Physical examination revealed dilated superficial veins, and laboratory tests showed elevated creatinine and D-dimer levels.

Observation:

  • Neurological causes for syncope were excluded.
  • Holter monitoring indicated ventricular extrasystoles; transesophageal stimulation of the left atrium was normal.
  • Coronary angiography revealed critical coronary artery stenoses.
  • Doppler examination identified left femoral vein obstruction.
  • CT scan showed inferior vena cava obstruction and abdominal wall vein dilation.

Findings:

  • The patient exhibited symptoms of thromboembolic disease, with suspected pulmonary embolism.
  • Surgical intervention was deemed too high-risk due to potential renal function decline.
  • Antithrombotic therapy was initiated to prevent embolic complications.

Implications:

  • This case underscores the complexity of managing patients with multiple coexisting cardiovascular and venous pathologies.
  • It emphasizes the necessity for a multidisciplinary approach involving comprehensive diagnostics and individualized therapy.
  • The case highlights the importance of considering thromboembolic disease in patients with unexplained syncope and venous distention.

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