Authors: Simon Odum / Editor: Jason M Kendall / Reviewer: Phil Delbridge, Maad Jasim / Codes: CC7, NeuP6, NeuP8, SLO1, SLO2, SLO3, SLO8, VC1, VC2 / Published: 18/12/2020 / Reviewed: 16/11/2024
A 65-year-old male presents to the emergency department (ED) by ambulance with an episode of collapse. He states that he was walking on level ground when his legs became “weak and heavy”. He was unable to walk any further and collapsed to the ground. There was no leg, abdominal, chest or head pain at any time. Shortly after collapsing to the ground he became very short of breath, pale and clammy. On arrival to the ED, he also complains of parasthaesia and numbness in his feet.
He is normally fit and healthy and takes no medication. He stopped smoking 2 years previously. There is no family history of significance.
On examination, he is apyrexial, but appears cold and clammy. His pulse is 80 and regular, his blood pressure is 100/60 and heart sounds are normal. Respiratory examination reveals oxygen saturation of 94% in room air, respiratory rate of 25 and widespread bilateral crepitations. Supplemental oxygen is commenced. Abdominal examination reveals no tenderness, no palpable masses and there are normal bowel sounds present. Neurological examination reveals a mild bilateral leg weakness. There are no femoral pulses present and both feet are cold, white and pulseless (confirmed with Dopplers).
14 Comments
Always good to be reminded of the rareties.
Thanks Simon excellent case.
Sad patient not survived.
As acute ischemia. Patient had
No pain?
Also any ECG changes?
As management Cath lab/interventional/hybrid , which option will be best ?
Unusual interesting case!
Lbbb ECG , acute heart failure , sudden onset lower limb weakness – nice points in the case
useful
Unusual presentation.
Thanks, very nice case
Good learning points!
interesting scenario, case presentation. thanks
Very unusual to have painless ischemia and collapse to the ground with gradual heavy legs & weakness without any other symptoms. Thanks for sharing this case presentation.
This case is far beyond our usual practice routine. Excellent case.Nice learning module.
Thanks 😊
Thought provoking case.
excellent case