The Case Files: A Blue Leg

Segerivas, Doni Marie DO; Sattler, Steven DO; Amblard, Louis MD A 49-year-old woman presented to the emergency department with a complaint of color change to her left leg while walking. She was watching a parade when she developed paresthesias to her left thigh and leg, and noticed her entire left thigh and leg were discolored and blue. She denies prior occurrence or any injury or trauma to the leg. She had no headache, weakness, change in vision, chest pain, shortness of breath, palpitations, abdominal pain, nausea, vomiting, diarrhea, or urinary symptoms. She had no history of prior thromboembolism or arterial pathology. She is not a smoker, and has not seen a physician for years. She also denied recent travel, oral contraceptives, recent surgery, any medical conditions, or surgical history. She stated that her leg appears slightly better than before, and the paresthesias have resolved. She is morbidly obese, and appears slightly anxious, with an elevated heart rate of 115 bpm. Her vital signs are otherwise within normal limits. Her entire leg from her inguinal ligament to her foot is mottled and slightly cyanotic with marked swelling. She has normal range of motion. Her leg is warm and not tender. Sensation is intact, and distal pulses are palpable. The rest of her physical exam is unremarkable. Her EKG is sinus tachycardia without ST/T wave changes. A heparin drip is empirically ordered before the negative Doppler of the left lower extremity study for DVT. Vascular surger...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research