SPLENIC AND RENAL INFARCTIONS COMPLICATING ATRIAL-FIBRILLATION

Splenic and renal infarctions are common manifestations of cardiac thr omboembolism Usually they remain clinically silent and are not likely to be diagnosed antemortem. Two elderly female patients, in whom nonrh eumatic chronic atrial fibrillation was noted, received low-dose aspir in. Both complained of the onset of acute abdominal pain and were foun d to have splenic and renal infarctions on abdominal computerized tomo graphy. An enlarged left atrium was seen on echocardiogram in both cas es. Treatment consisted of hydration, analgesics, and anticoagulation. In one case, liquefactive necrosis of the splenic infarct was observe d on subsequent computer tomography studies. Both patients did well an d remained free of new embolic events in the following 6 and 10 months , respectively. Clinicians should readily recognize the clinical manif estations of splenic and renal infarctions in patients with atrial fib rillation. Abdominal computerized tomography can confirm the diagnosis .