[Inferior vena cava obstruction in patient with coronary artery disease].

76-year-old male with inferior myocardial infarction and right nephrectomy due to cancer in the past, was admitted to our Department due to incidents of chest pain and syncope. During physical examination we found dilated superficial veins of abdomen, chest and lower extremities. Laboratory tests, except creatinine and D-dimer levels were normal. Consulting neurologist excluded neurological reasons of syncope. Holter monitoring showed ventricular extrasystolies and results of transesophageal stimulation of left atrium were normal. Coronary angiogram demonstrated critical stenoses in some of the coronary arteries. Doppler examination showed left femoral vein obstruction. Computer tomography of abdominal cavity demonstrated inferior vena cava obstruction and abdominal wall veins dilatation. Due to thromboembolic disease symptoms pulmonary embolism was suspected. Consulting surgeon and cardiosurgeon decide against surgery due to it's extensive risk, among other things due to possibility of renal function worsening. To prevent embolic complications patient started antithrombotic therapy. Our patient's case shows many vital pathologies in cardio vascular system which occur in one subject. His example demonstrates need to perform multidirectional diagnostics and therapy of such patients.