Clinical presentation
A 54-year-old male patient presented to the emergency department with a painful right hand which was pale and cold. The vital signs were 85 beats per minute of heart rate, 120/80 mmHg measured blood pressure, 20 breaths per minute of respiratory rate and 98% of oxygen saturation in room air. The physical examination findings of cardiovascular, respiratory, and gastrointestinal systems were normal. Extremity examinations showed right hand and forearm cold, pulseless and hypoesthetic without loss of motor functions.
The color Doppler ultrasound of the right upper extremity were performed, and acute long segment thrombosis of the axillary artery were detected. Biochemical tests were normal other than high glucose and D-Dimer test results. Electrocardiogram showed normal sinus rhythm with complete right bundle branch block and left anterior fascicular block, normal PR and QTc intervals and no ischemic changes of ST-T segments (Figure 1).