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Rapid heparinization as a decisive strategy for acute upper limb ischemia: a case report

Heart Science Journal · Vol. 6 No. 2 (2025)

DOI
10.21776/ub.hsj.2025.006.02.21
ISSN
2721-9984, 2721-9976
Terbit
2025-04-30
Penerbit
Universitas Brawijaya
Bahasa
en
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Acute upper limb ischemia is a rare clinical presentation of thromboembolism, mostly known in patients with atrial fibrillation. Both conservative and surgical procedures are available as alternatives to therapy. In this case report, a patient who had been diagnosed with acute upper limb ischemia received immediate heparin administration in order to protect the upper limb and restore its functional capabilities. Case Illustration: A 60-year-old male presented with acute pain and numbness, along with bluishness and a cold sensation in the right hand. He has unrestricted arm mobility. The patient has a medical background of atrial fibrillation for over 11 years. The right hand exhibited reduced peripheral saturation, pulselessness, pain, pallor, and poikilothermy, but neither paresthesia nor paralysis. Duplex ultrasonography showed no detectable blood flow from the right brachial artery up to the distal arteries. However, the vein remained audible. The patient received heparinization immediately. Conclusion: Immediate identification and administration of heparin in instances of acute upper limb ischemia (AULI) are crucial for achieving favorable outcomes and a good prognosis. Continued treatment with anticoagulants is necessary for the therapeutic intervention in order to enhance limb preservation, minimize complications, and ensure patients have an excellent quality of life subsequent to conservative treatment.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
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Rekan penulisOrganisasiArtikel bersama
Mohammad Saifur RohmanUniversity of Brawijaya15
Cholid Tri TjahjonoUniversity of Brawijaya12
Sasmojo WiditoUniversity of Brawijaya11
Djanggan SargowoUniversity of Brawijaya10
Ardian RizalUniversity of Brawijaya9
Anna Fuji RahimahUniversity of Brawijaya8
Budi SatrijoUniversity of Brawijaya7
Heny MartiniUniversity of Brawijaya6
Indra PrasetyaUniversity of Brawijaya6
Setyasih AnjarwaniUniversity of Brawijaya4
Seprian WidasmaraUniversity of Brawijaya3
Adhika Prastya WikanandaUniversity of Brawijaya3
Sawitri SatwikajatiUniversity of Brawijaya3
Putri Annisa KamilaUniversity of Brawijaya2
Irma KameliaUniversity of Brawijaya2
Dyah Ayu IkeningrumRSUD Prof. Dr. Saiful Anwar Malang2
Oktafin Srywati PamunaUniversity of Brawijaya2
Zainal FathurohimUniversity of Brawijaya2
Nikhen NoverikeUniversity of Brawijaya2
Titin Andri WihastutiUniversity of Brawijaya2
Ira Vori NugrohoUniversity of Brawijaya2
Imam Mi'raj SuprayogaUniversity of Brawijaya2
Dea Arie KurniawanUniversity of Brawijaya2
Malombassi Dharmawan Hadiwidjojo HutomoUniversity of Brawijaya2
Ryan RamadhanUniversity of Brawijaya1
Ardian RizalUniversity of Brawijaya1
Veny KurniawatiUniversity of Brawijaya1
Aris Munandar Zulkifli IsmailUniversity of Brawijaya1
Dedy IrawanUniversity of Brawijaya1
Monika SitioUniversity of Brawijaya1
Muhammad Rizki FadlanUniversity of Brawijaya1
Liemena Harold AdrianRSUD Prof. Dr. Saiful Anwar Malang1
Ayu Asri Devi AdityawatiUniversity of Brawijaya1
Anna Fuji RahimahAfiliasi tidak diketahui1
Imelda KrisnasariUniversity of Brawijaya1
Fahmy RusnantaUniversity of Brawijaya1
Yudi Putra ApridityaUniversity of Brawijaya1
Ratna PancasariUniversity of Brawijaya1

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Rapid heparinization as a decisive strategy for acute upper limb ischemia: a case report</dc:title>
	<dc:creator xml:lang="en">Veliawan, Zhafran</dc:creator>
	<dc:creator xml:lang="en">Kurnianingsih, Novi</dc:creator>
	<dc:subject xml:lang="en">Acute upper limb ischemic</dc:subject>
	<dc:subject xml:lang="en">revascularization</dc:subject>
	<dc:subject xml:lang="en">Atrial fibrillation</dc:subject>
	<dc:subject xml:lang="en">anticoagulation</dc:subject>
	<dc:description xml:lang="en">Background: Acute upper limb ischemia is a rare clinical presentation of thromboembolism, mostly known in patients with atrial fibrillation. Both conservative and surgical procedures are available as alternatives to therapy. In this case report, a patient who had been diagnosed with acute upper limb ischemia received immediate heparin administration in order to protect the upper limb and restore its functional capabilities.
Case Illustration: A 60-year-old male presented with acute pain and numbness, along with bluishness and a cold sensation in the right hand. He has unrestricted arm mobility. The patient has a medical background of atrial fibrillation for over 11 years. The right hand exhibited reduced peripheral saturation, pulselessness, pain, pallor, and poikilothermy, but neither paresthesia nor paralysis. Duplex ultrasonography showed no detectable blood flow from the right brachial artery up to the distal arteries. However, the vein remained audible. The patient received heparinization immediately.
Conclusion: Immediate identification and administration of heparin in instances of acute upper limb ischemia (AULI) are crucial for achieving favorable outcomes and a good prognosis. Continued treatment with anticoagulants is necessary for the therapeutic intervention in order to enhance limb preservation, minimize complications, and ensure patients have an excellent quality of life subsequent to conservative treatment.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2025-04-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20261</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2025.006.02.21</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2025.006.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20261/504</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2025 Zhafran Veliawan</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>