van Vonderen JJ, Keus JMH, van Schaik J, Smiers FJ, Ten Harkel DJ, Lopriore E. A neonate with spontaneous arterial limb ischemia and an aneurysm of the oval foramen: a case report.
J Med Case Rep 2021;
15:536. [PMID:
34696819 PMCID:
PMC8543854 DOI:
10.1186/s13256-021-03078-9]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background
In this case report, we describe a very rare case of severe limb ischemia due to an arterial embolus caused by an aneurysm of the oval foramen in a term-born infant that occurred in the first few hours after birth.
Case presentation
A newborn male Caucasian patient presented on the maternity ward with ischemia of the right foot. Ischemia was treated with nitroglycerin spray and low-molecular-weight heparin in therapeutic dosage. An aneurysm of the oval foramen was found during postnatal echocardiography screening. This was thought to be the source of an embolus causing limb ischemia. At birth and upon follow-up, no clotting disorders were found. A large part of the right forefoot was ischemic, leading to loss of digits 1, 2, and 3. No significant loss of function was found in the first year of life.
Conclusion
Severe limb ischemia can be caused by an embolus arising from an aneurysm of the oval foramen and can be treated with heparin.
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