Arterial emboli of the upper extremity presenting as ischemic heart disease: case report and review.

A case of brachial artery embolism presenting as ischemic coronary artery disease is presented. The patient presented with sudden onset of left arm pain, shortness of breath, nausea, vomiting, and diaphoresis. Initial relief with sublingual nitroglycerin was seen. With further evaluation, a brachial artery embolus was diagnosed, and an embolectomy was successfully performed. Delay in diagnosis and treatment can lead to substantial morbidity, including gangrene and amputation. Misdiagnosis is common, as it is seen in the same patients at risk for ischemic heart disease, stroke, and other vascular abnormalities. An awareness of this problem is important among those who initially evaluate patients in emergency departments.