Acute Limb Ischaemia Case 2

An 80-year-old female presents with a 12-hour history of a painful, cold right leg. On examination she is unable to move her right leg and has no pulses palpable on that side. Her ECG is shown here.

What is the likely cause of her leg ischaemia?

Click on the ECG to enlarge.

You give her oxygen and 5000 units IV heparin.

Which signs would suggest that urgent revascularisation is indicated?

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What findings on examination would suggest irreversible ischaemia?

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She has a very cold foot with fixed mottling and complete anaesthesia and paralysis of her toes. She also has some tenderness on squeezing her calf.

What does the calf tenderness suggest?

What would be the dangers of revascularisation in this case?

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What is her predicted mortality following this episode?