5th July 2024

A 65-year-old man with a history of HTN & T2DM presented to ED with central chest pain for 2 hours

A 65-year-old man with a history of HTN & T2DM presented to ED with central chest pain for 2 hours. An ECG showed ST-elevation in the anterior leads. He underwent primary PCI. Two days after the procedure, his blood tests showed the following:

Hb 100g/L (115-165), WBC 12.7×10⁹/L (4-11), Neutrophils 9.8×10⁹/L (2-8), Eosinophils 1.1×10⁹/L (0.1-0.4), Platelets 120×109/L (150-400), Na 136 mmol/L (135-145), K 4.0 mmol/L (3.5-5), Urea 9 mmol/L (2.5-7.5), Creatinine 225 μmol/L (60-110).

He was noted to have low urine output. Urine dipstick Showed 1+ protein and 1+ blood. On examination, he was noted to have weak pulses on both dorsalis pedis arteries along with a purple rash on his right foot. What is the most likely cause of AKI?

Select the SINGLE most appropriate option from the list below. Select ONE option only.