Splenic Infarction and Recurrent Pulmonary Embolism in Atrial Fibrillation Associated With Subtherapeutic Anticoagulation and Medication Nonadherence: A Case Report - PubMed
4 hours ago
- #Atrial Fibrillation
- #Splenic Infarction
- #Pulmonary Embolism
- Atrial fibrillation (AF) is a major cause of cardioembolic stroke and systemic thromboembolism.
- Splenic infarction (SI) is a rare extracerebral manifestation of systemic embolization, often presenting with nonspecific abdominal pain.
- A 60-year-old man with chronic AF on warfarin presented with acute abdominal pain, splenic infarcts, pulmonary emboli, and left atrial appendage thrombus due to subtherapeutic anticoagulation.
- Despite receiving parenteral anticoagulation and transition to apixaban at discharge, the patient did not initiate the prescribed medication and returned with recurrent pulmonary embolism.
- The case highlights the importance of vigilant therapeutic monitoring, careful transitions between anticoagulation regimens, and early imaging for unexplained abdominal pain in anticoagulated patients.
- Nonadherence and fluctuating anticoagulation control can lead to recurrent and potentially life-threatening embolic complications.