Leriche syndrome in a patient with acute pulmonary embolism and acute myocardial infarction: a case report and review of literature

Leriche syndrome: Clinical and diagnostic approach of a rare infrarenal aortoiliac occlusive disease

Leriche syndrome is an aortoiliac occlusive arterial disease comprising decreased peripheral pulses, claudication, and erectile dysfunction. We present a case of a 60-year-old male with abdominal pain and hematochezia who was diagnosed with hemorrhoids. The patient also had associated leg cramps on both sides and lower limb weakness. Further evaluation of the patient with imaging revealed occlusion of the distal descending abdominal aorta below the level of renal arteries and the iliac arteries. An incidental finding of Leriche syndrome was evident. This case report contributes to the current literature when any patient with abdominal pain and bilateral lower limb weakness, Leriche syndrome should be considered to avoid complications as it has high morbidity and mortality.

Aortoiliac Occlusion in a Rare Instance of Leriche Syndrome Type I in a 65-Year-Old Woman With Chronic Leg Discomfort Refractory to Pregabalin

Aortoiliac occlusive disease (AIOD), also known as Leriche syndrome, is a form of peripheral artery disease (PAD) that involves narrowing, and in severe cases, complete occlusion, of infrarenal abdominal aorta and/or iliac and femoropopliteal arteries. It classically presents as a triad of symptoms, i.e., leg pain, erectile dysfunction, and abnormally weak or absent femoral pulses. If untreated, it can progress to ischemia and gangrene of the affected regions of pelvis and lower extremities. Like any other PAD, AIOD is most commonly caused by atherosclerosis and usually occurs in strong association with severe cardiovascular diseases. Due to the rarity of this disease, its incidence and prevalence are still unknown making it harder to diagnose especially in patients without the classic risk factors and typical presentation. We report a case of AIOD in a 65-year-old woman who presented with atypical symptoms. She was diagnosed with AIOD type I upon further investigation, which was managed successfully.

The effect of emergency nursing on the mental health and limb function recovery of myocardial infarction patients

OBJECTIVE

To evaluate the effect of emergency care on the mental health and recovery of limb function in myocardial infarction (MI) patients.

METHODS

We recruited 106 MI patients consecutively admitted to the emergency center of our hospital from June, 2016 to January, 2019. Among them, 51 underwent routine care (the control group) and 55 underwent emergency care (the observation group). The rescue success rates, the pre-hospital times, the emergency rescue times, and the door-to-balloon times were recorded and compared. The patients' heart rates, respiratory frequencies, and blood pressure levels were monitored after the care. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to evaluate the patients' psychological states. The patients' limb function and activities of daily living (ADL) were evaluated using the Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI), respectively. The incidences of complications were compared between the two groups. The Short-Form 36 Item Health Survey (SF-36) was used to evaluate the patients' quality of life (QOL), and a self-made satisfaction questionnaire was developed to evaluate the patient satisfaction.

RESULTS

After the emergency care, there was a higher rescue success rate and shorter pre-hospital times, emergency rescue times, and door-to-balloon times in the observation group. The heart rates, respiratory frequencies, and blood pressure levels in the observation group were more stable than they were in the control group. The patients in the observation group had lower SAS and SDS scores (P<0.05), lower FMA and lower MBI (P<0.05), as well as a lower incidence of complications (P<0.05). The QOL was greatly improved in the observation group after two weeks of care. The patients in the observation group were more satisfied with the nursing service than the patients in the control group (P<0.05).

CONCLUSION

Emergency care contributes to the improvement of mental health and limb function, as well as MI patient prognosis, so it is well worthy of promoting.