Lower Extremity Compartment Syndrome After Coronary Artery Bypass: Easy to Miss Unless Suspected

Area of Science:

• Cardiovascular Surgery
• Surgical Complications
• Orthopedics

Background:

• Coronary artery bypass grafting (CABG) is a common cardiac procedure.
• Acute compartment syndrome (ACS) is a surgical emergency characterized by increased pressure within a fascial compartment.
• ACS following CABG is exceptionally rare and often overlooked.

Observation:

• A patient presented with symptoms that confounded the diagnosis of ACS post-CABG.
• The clinical presentation mimicked other common post-cardiac surgery complications.
• This led to a delay in the definitive diagnosis of ACS.

Findings:

• The case highlights the diagnostic challenges of ACS in the context of recent CABG.
• Delayed diagnosis of ACS can lead to severe functional deficits and limb loss.
• Active consideration of ACS is necessary even in atypical presentations after CABG.

Implications:

• Clinicians should maintain a high index of suspicion for ACS in patients with concerning symptoms after CABG.
• Prompt recognition and surgical intervention are critical for limb salvage.
• This case underscores the importance of considering rare complications in complex surgical patients.