Infarto renal, un sitio atípico de embolismo como debut de fibrilación auricular. Reporte de caso y revisión de la literatura
Resumen
La fibrilación auricular (FA) es la arritmia sostenida más común y su incidencia y prevalencia está aumentando en todo el mundo. La FA cumple los criterios de la tríada de Wirchow, que son necesarios para la formación de trombos: estasis sanguínea, disfunción endotelial y activación de la coagulación. Los acontecimientos clínicos relacionados con la trombosis se han atribuido esencialmente a la formación de trombos en la aurícula izquierda con el consiguiente embolismo a circulación cerebral y periférica. Presentamos un caso en un paciente con factores de riesgo cardiovascular por edad, sexo y comorbilidades, FA previamente subclínica, quien debuta con tromboembolismo de arteria renal derecha, ocasionando un infarto renal agudo, un sitio poco común dentro de los sitios de embolismo asociados a FA, con cuadro clínico poco específico, sesgado por lesión hepática benigna, el cual se documentó por angiotomografía, se inició terapia anticoagulante sistémica y antiplaquetaria local, con buenos desenlaces clínicos.
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Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström-Lundqvist, C., Boriani, G., Castella, M., Dan, G.-A., Dilaveris, P. E., Fauchier, L., Filippatos, G., Kalman, J. M., La Meir, M., Lane, D. A., Lebeau, J.-P., Lettino, M., Lip, G. Y., Pinto, F. J., … Zakirov, N. U. (2020). 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (eacts). European Heart Journal, 42(5), 373–498. https://doi.org/10.1093/eurheartj/ehaa612
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., Gorenek, B., Hess, P. L., Hlatky, M., Hogan, G., Ibeh, C., Indik, J. H., Kido, K., Kusumoto, F., Link, M. S., … Van Wagoner, D. R. (2024). 2023 ACC/AHA/ACCP/hrs guideline for the diagnosis and management of Atrial Fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 149(1). https://doi.org/10.1161/cir.0000000000001193
Weng, L.-C., Preis, S. R., Hulme, O. L., Larson, M. G., Choi, S. H., Wang, B., Trinquart, L., McManus, D. D., Staerk, L., Lin, H., Lunetta, K. L., Ellinor, P. T., Benjamin, E. J., & Lubitz, S. A. (2018). Genetic predisposition, clinical risk factor burden, and lifetime risk of atrial fibrillation. Circulation, 137(10), 1027–1038. https://doi.org/10.1161/circulationaha.117.031431
Staerk, L., Wang, B., Preis, S. R., Larson, M. G., Lubitz, S. A., Ellinor, P. T., McManus, D. D., Ko, D., Weng, L.-C., Lunetta, K. L., Frost, L., Benjamin, E. J., & Trinquart, L. (2018). Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: Cohort study based on longitudinal data from the Framingham Heart Study. BMJ. https://doi.org/10.1136/bmj.k1453
Rattanawong, P., Upala, S., Riangwiwat, T., Jaruvongvanich, V., Sanguankeo, A., Vutthikraivit, W., & Chung, E. H. (2018). Atrial fibrillation is associated with Sudden cardiac death: A systematic review and meta-analysis. Journal of Interventional Cardiac Electrophysiology, 51(2), 91–104. https://doi.org/10.1007/s10840-017-0308-9
Emdin, C. A., Wong, C. X., Hsiao, A. J., Altman, D. G., Peters, S. A., Woodward, M., & Odutayo, A. A. (2016). Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: Systematic review and meta-analysis of Cohort studies. BMJ. https://doi.org/10.1136/bmj.h7013
Odutayo, A., Wong, C. X., Hsiao, A. J., Hopewell, S., Altman, D. G., & Emdin, C. A. (2016). Atrial fibrillation and risks of cardiovascular disease, renal disease, and Death: Systematic Review and meta-analysis. BMJ, i4482. https://doi.org/10.1136/bmj.i4482
Brambatti, M., Connolly, S. J., Gold, M. R., Morillo, C. A., Capucci, A., Muto, C., Lau, C. P., Van Gelder, I. C., Hohnloser, S. H., Carlson, M., Fain, E., Nakamya, J., Mairesse, G. H., Halytska, M., Deng, W. Q., Israel, C. W., & Healey, J. S. (2014). Temporal relationship between subclinical atrial fibrillation and embolic events. Circulation, 129(21), 2094–2099.
https://doi.org/10.1161/circulationaha.113.007825
Lin, A. L., Nah, G., Tang, J. J., Vittinghoff, E., Dewland, T. A., & Marcus, G. M. (2022). Cannabis, cocaine, methamphetamine, and opiates increase the risk of incident atrial fibrillation. European Heart Journal, 43(47), 4933–4942. https://doi.org/10.1093/eurheartj/ehac558
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Virani, S. S., Williams, K. A., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140(11). https://doi.org/10.1161/cir.0000000000000678
Wong, C. X., Sullivan, T., Sun, M. T., Mahajan, R., Pathak, R. K., Middeldorp, M., Twomey, D., Ganesan, A. N., Rangnekar, G., Roberts-Thomson, K. C., Lau, D. H., & Sanders, P. (2015). Obesity and the risk of incident, post-operative, and post-ablation atrial fibrillation. JACC: Clinical Electrophysiology, 1(3), 139–152. https://doi.org/10.1016/j.jacep.2015.04.004
Parajuli, P., Luitel, B. R., Chapagain, S., Pradhan, M. M., Gnyawali, D., Sigdel, P. R., Pandit, D., Guragain, B., Chudal, S., Verma, R., Poudyal, S., Chalise, P. R., & Sharma, U. K. (2020). Segmental renal artery and popliteal artery embolism in an adult patient with rheumatic heart disease and atrial fibrillation: A case report. International Journal of Surgery Case Reports, 77, 602–604. https://doi.org/10.1016/j.ijscr.2020.11.097
Ge, T., Zhu, Z., Wang, J., Zhou, W., Song, E. J., & Tang, S. (2022). A rare cause of abdominal pain managed unconventionally: Acute renal infarction caused by atrial fibrillation: A case report. Journal of Medical Case Reports, 16(1). https://doi.org/10.1186/s13256-022-03608-z
Scolari, F., & Ravani, P. (2010). Atheroembolic renal disease. The Lancet, 375(9726), 1650–1660. https://doi.org/10.1016/s0140-6736(09)62073-0
Watson, T., Shantsila, E., & Lip, G. Y. (2009). Mechanisms of thrombogenesis in atrial fibrillation: Virchow’s Triad revisited. The Lancet, 373(9658), 155–166. https://doi.org/10.1016/s0140-6736(09)60040-4
Chatterjee, N. A., & Lubitz, S. A. (2015). Systemic embolic events (see) in atrial fibrillation. Circulation, 132(9), 787–789. https://doi.org/10.1161/circulationaha.115.018172
Singh, S., Wang, L., Jyotimallika, J., Singh, S., & Yao, Q. (2014). Spontaneous renal artery thrombosis: An unusual cause of acute abdomen. North American Journal of Medical Sciences, 6(5), 234. https://doi.org/10.4103/1947-2714.132944
Poggiali E, Ferrari MG, Botti C, Michieletti E, Vercelli A. Renal artery thrombosis. A case of acute flank pain in a patient with a new onset of renal failure and atrial fibrillation. Acta Biomed. 2023 Jun 14;94(3):e2023140. doi: 10.23750/abm.v94i3.14427
Bolderman, R., Oyen, R., Verrijcken, A., Knockaert, D., & Vanderschueren, S. (2006). Idiopathic renal infarction. The American Journal of Medicine, 119(4).
https://doi.org/10.1016/j.amjmed.2005.06.049
Koivuviita, N., Tertti, R., Heiro, M., Manner, I., & Metsärinne, K. (2014). Thromboembolism as a cause of renal artery occlusion and acute kidney injury: The recovery of kidney function after two weeks. Case Reports in Nephrology and Dialysis, 4(1), 82–87.
https://doi.org/10.1159/000362538
Glück, G., Croitoru, M., Deleanu, D., & Platon, P. (2000). Local thrombolytic treatment for renal arterial embolism. European Urology, 38(3), 339–343. https://doi.org/10.1159/000020303
Silverberg, D., Menes, T., Rimon, U., Salomon, O., & Halak, M. (2016). Acute renal artery occlusion: Presentation, treatment, and outcome. Journal of Vascular Surgery, 64(4), 1026–1032. https://doi.org/10.1016/j.jvs.2016.04.043
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Virani, S. S., Williams, K. A., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140(11). https://doi.org/10.1161/cir.0000000000000678
Brambatti, M., Connolly, S. J., Gold, M. R., Morillo, C. A., Capucci, A., Muto, C., Lau, C. P., Van Gelder, I. C., Hohnloser, S. H., Carlson, M., Fain, E., Nakamya, J., Mairesse, G. H., Halytska, M., Deng, W. Q., Israel, C. W., & Healey, J. S. (2014). Temporal relationship between subclinical atrial fibrillation and embolic events. Circulation, 129(21), 2094–2099.
https://doi.org/10.1161/circulationaha.113.007825
Bolderman, R., Oyen, R., Verrijcken, A., Knockaert, D., & Vanderschueren, S. (2006). Idiopathic renal infarction. The American Journal of Medicine, 119(4).
https://doi.org/10.1016/j.amjmed.2005.06.049
Chatterjee, N. A., & Lubitz, S. A. (2015). Systemic embolic events (see) in atrial fibrillation. Circulation, 132(9), 787–789. https://doi.org/10.1161/circulationaha.115.018172
Emdin, C. A., Wong, C. X., Hsiao, A. J., Altman, D. G., Peters, S. A., Woodward, M., & Odutayo, A. A. (2016). Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: Systematic review and meta-analysis of Cohort studies. BMJ. https://doi.org/10.1136/bmj.h7013
Ge, T., Zhu, Z., Wang, J., Zhou, W., Song, E. J., & Tang, S. (2022). A rare cause of abdominal pain managed unconventionally: Acute renal infarction caused by atrial fibrillation: A case report. Journal of Medical Case Reports, 16(1). https://doi.org/10.1186/s13256-022-03608-z
Glück, G., Croitoru, M., Deleanu, D., & Platon, P. (2000). Local thrombolytic treatment for renal arterial embolism. European Urology, 38(3), 339–343. https://doi.org/10.1159/000020303
Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström-Lundqvist, C., Boriani, G., Castella, M., Dan, G.-A., Dilaveris, P. E., Fauchier, L., Filippatos, G., Kalman, J. M., La Meir, M., Lane, D. A., Lebeau, J.-P., Lettino, M., Lip, G. Y., Pinto, F. J., … Zakirov, N. U. (2020). 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (eacts). European Heart Journal, 42(5), 373–498. https://doi.org/10.1093/eurheartj/ehaa612
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., Gorenek, B., Hess, P. L., Hlatky, M., Hogan, G., Ibeh, C., Indik, J. H., Kido, K., Kusumoto, F., Link, M. S., … Van Wagoner, D. R. (2024). 2023 ACC/AHA/ACCP/hrs guideline for the diagnosis and management of Atrial Fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 149(1).
https://doi.org/10.1161/cir.0000000000001193
Koivuviita, N., Tertti, R., Heiro, M., Manner, I., & Metsärinne, K. (2014). Thromboembolism as a cause of renal artery occlusion and acute kidney injury: The recovery of kidney function after two weeks. Case Reports in Nephrology and Dialysis, 4(1), 82–87. https://doi.org/10.1159/000362538
Lin, A. L., Nah, G., Tang, J. J., Vittinghoff, E., Dewland, T. A., & Marcus, G. M. (2022). Cannabis, cocaine, methamphetamine, and opiates increase the risk of incident atrial fibrillation. European Heart Journal, 43(47), 4933–4942. https://doi.org/10.1093/eurheartj/ehac558
Odutayo, A., Wong, C. X., Hsiao, A. J., Hopewell, S., Altman, D. G., & Emdin, C. A. (2016). Atrial fibrillation and risks of cardiovascular disease, renal disease, and Death: Systematic Review and meta-analysis. BMJ, i4482. https://doi.org/10.1136/bmj.i4482
Parajuli, P., Luitel, B. R., Chapagain, S., Pradhan, M. M., Gnyawali, D., Sigdel, P. R., Pandit, D., Guragain, B., Chudal, S., Verma, R., Poudyal, S., Chalise, P. R., & Sharma, U. K. (2020). Segmental renal artery and popliteal artery embolism in an adult patient with rheumatic heart disease and atrial fibrillation: A case report. International Journal of Surgery Case Reports, 77, 602–604. https://doi.org/10.1016/j.ijscr.2020.11.097
Poggiali E, Ferrari MG, Botti C, Michieletti E, Vercelli A. Renal artery thrombosis. A case of acute flank pain in a patient with a new onset of renal failure and atrial fibrillation. Acta Biomed. 2023 Jun 14;94(3):e2023140. doi: 10.23750/abm.v94i3.14427
Rattanawong, P., Upala, S., Riangwiwat, T., Jaruvongvanich, V., Sanguankeo, A., Vutthikraivit, W., & Chung, E. H. (2018). Atrial fibrillation is associated with Sudden cardiac death: A systematic review and meta-analysis. Journal of Interventional Cardiac Electrophysiology, 51(2), 91–104. https://doi.org/10.1007/s10840-017-0308-9
Scolari, F., & Ravani, P. (2010). Atheroembolic renal disease. The Lancet, 375(9726), 1650–1660. https://doi.org/10.1016/s0140-6736(09)62073-0
Silverberg, D., Menes, T., Rimon, U., Salomon, O., & Halak, M. (2016). Acute renal artery occlusion: Presentation, treatment, and outcome. Journal of Vascular Surgery, 64(4), 1026–1032. https://doi.org/10.1016/j.jvs.2016.04.043
Singh, S., Wang, L., Jyotimallika, J., Singh, S., & Yao, Q. (2014). Spontaneous renal artery thrombosis: An unusual cause of acute abdomen. North American Journal of Medical Sciences, 6(5), 234. https://doi.org/10.4103/1947-2714.132944
Staerk, L., Wang, B., Preis, S. R., Larson, M. G., Lubitz, S. A., Ellinor, P. T., McManus, D. D., Ko, D., Weng, L.-C., Lunetta, K. L., Frost, L., Benjamin, E. J., & Trinquart, L. (2018). Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: Cohort study based on longitudinal data from the Framingham Heart Study. BMJ. https://doi.org/10.1136/bmj.k1453
Watson, T., Shantsila, E., & Lip, G. Y. (2009). Mechanisms of thrombogenesis in atrial fibrillation: Virchow’s Triad revisited. The Lancet, 373(9658), 155–166. https://doi.org/10.1016/s0140-6736(09)60040-4
Weng, L.-C., Preis, S. R., Hulme, O. L., Larson, M. G., Choi, S. H., Wang, B., Trinquart, L., McManus, D. D., Staerk, L., Lin, H., Lunetta, K. L., Ellinor, P. T., Benjamin, E. J., & Lubitz, S. A. (2018). Genetic predisposition, clinical risk factor burden, and lifetime risk of atrial fibrillation. Circulation, 137(10), 1027–1038. https://doi.org/10.1161/circulationaha.117.031431
Wong, C. X., Sullivan, T., Sun, M. T., Mahajan, R., Pathak, R. K., Middeldorp, M., Twomey, D., Ganesan, A. N., Rangnekar, G., Roberts-Thomson, K. C., Lau, D. H., & Sanders, P. (2015). Obesity and the risk of incident, post-operative, and post-ablation atrial fibrillation. JACC: Clinical Electrophysiology, 1(3), 139–152. https://doi.org/10.1016/j.jacep.2015.04.004
Derechos de autor 2024 Dalia Fernanda Aguilar Medellín
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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