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Differential Diagnosis for Arterial Hypercoagulability Causing Infarct

Single Most Likely Diagnosis

  • Atrial Fibrillation: This condition is a common cause of arterial embolism leading to infarcts, particularly in the context of stroke. The irregular heartbeat can lead to blood clot formation, which may then embolize.

Other Likely Diagnoses

  • Deep Vein Thrombosis (DVT) with Embolization: While DVT typically refers to venous thrombosis, parts of the clot can break off and travel through the heart to the arterial system, especially in the presence of a patent foramen ovale, leading to arterial infarcts.
  • Hypercoagulable States (e.g., Factor V Leiden, Protein C/S Deficiency): These conditions increase the risk of forming blood clots that can cause infarcts by obstructing arteries.
  • Antiphospholipid Syndrome: An autoimmune disorder that increases the risk of blood clots, including those that can cause arterial infarcts.

Do Not Miss Diagnoses

  • Left Ventricular (LV) Thrombus: Although less common than other sources of embolism, an LV thrombus can indeed cause arterial infarcts by embolizing to smaller arteries. This is particularly concerning in the setting of myocardial infarction or cardiomyopathy.
  • Endocarditis: Infective endocarditis can lead to the formation of vegetations on heart valves, which can embolize and cause infarcts in various organs.
  • Aortic Atheroma: Large atheromas in the aorta can be a source of emboli, leading to infarcts in downstream organs.

Rare Diagnoses

  • Paradoxical Embolism: This occurs when a venous thromboembolus crosses from the right side of the heart to the left through a defect, such as a patent foramen ovale, and then travels to the arterial system, causing an infarct.
  • Cholesterol Crystal Embolism: This rare condition occurs when cholesterol crystals break off from plaques in the arteries and travel to smaller arteries, causing occlusion and infarct.
  • Tumor Embolism: Certain tumors, like renal cell carcinoma or hepatocellular carcinoma, can embolize and cause infarcts in distant organs, although this is exceedingly rare.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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