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From the Research
Workup for Splenic Infarction in Heart Failure
The workup for splenic infarction in the setting of heart failure (HF) involves several diagnostic approaches. Some key points to consider include:
- The spleen plays a significant role in immune function and hemodynamics, and its size can reflect systemic circulating blood volume status and sympathetic nerve activity 1.
- Splenic infarction can be associated with cardiac thromboembolism, and other systemic pathologies, infections, or trauma may also lead to this occurrence 2.
- Computed tomography (CT) scans are a crucial diagnostic tool for evaluating splenic infarction, and repeat abdominal CT scans may be necessary to confirm recovery of the spleen 3.
- The clinical, hematological, biochemical, and radiological characteristics of patients with splenic infarction can provide valuable information for diagnosis and prognosis, including leukocytosis, a decrease of lymphocytes, anemia, hypoalbuminemia, and liver dysfunction 4.
Diagnostic Considerations
Some important diagnostic considerations for splenic infarction in HF include:
- CT volumetry to measure splenic size and volume index (SVI) 1.
- Laboratory tests, such as complete blood counts, coagulation markers, transaminases, lactate dehydrogenase (LDH), and blood urea nitrogen, to evaluate prognosis and guide management 4.
- Assessment of cardiac function and hemodynamics, including cardiac output, stroke volume, and systemic vascular resistance 1.
- Evaluation for potential complications, such as pseudocysts, abscesses, hemorrhage, subcapsular hematoma, or splenic rupture 2.
Prognostic Factors
Some prognostic factors for splenic infarction in HF include:
- SVI, which is positively correlated with cardiac output and stroke volume, and negatively correlated with systemic vascular resistance 1.
- Leukocytosis, a decrease of lymphocytes, elongated activated partial thromboplastin time, decrease of fibrinogen, liver dysfunction, elevation of LDH, and blood urea nitrogen, which can predict prognosis 4.
- The presence of cancer, atrial fibrillation, or infection, which can increase the risk of splenic infarction 4.