Haematology
Case 24: A Patient Who Has Undergone a Coronary Artery Bypass
CASE
A 74‐year‐old man underwent a coronary artery bypass graft 7 days ago. He has a past medical history of type 2 diabetes and hypertension for which he takes gliclazide and ramipril. He also takes regular aspirin (which was stopped prior to surgery) and simvastatin. Since the surgery, he has been unwell on the intensive care unit requiring inotropic support and haemofiltration. Over the last 24 hours, the haemofiltration circuit has been frequently clotting off and the patient has been complaining of a painful left leg. On examination the leg is pale and no peripheral pulses could be identified. His blood counts over the last few days are as follows:
Days post‐op: 2 4 5 6 Hb (g/dL) 11.4 11.8 10.9 11.2 WCC (×109/L) 12.6 13.5 13.8 12.9 PLT (×109/L) 250 270 150 75
Three days ago the patient was prescribed broad‐spectrum antibiotics for presumed sepsis.
QUESTION 1
Your score this session: 0 of 0
What is the most likely diagnosis?