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What initially appeared to be a possible cardiac or neurological problem soon became a critical vascular emergency for a 35-year-old schoolteacher who arrived with severe pain, tingling and numbness in his right hand, accompanied by bluish discolouration of several fingers. With the risk of permanent damage to the limb increasing by the hour, timely diagnosis and intervention became crucial. At Manipal  Hospital Broadway, a multidisciplinary team led by Dr. Anindya Sundar Sarkar, Senior Emergency Medical Officer, Dr. Arijit Ghosh, HOD – Interventional Cardiology, and Dr. Jayanta Das, Department of Vascular Surgery, acted swiftly to identify and address the underlying vascular problem. Through advanced intervention and coordinated critical care, the team successfully restored blood flow, saving the patients limb and enabling him to make a complete recovery without any residual deficit. The timely intervention averted a potentially life-altering outcome, underscoring the importance of recognising and treating acute vascular emergencies without delay.



Rajib Saha (name changed) was admitted with a history of hypertension (on Telma AM), presenting with a 3–4-day history of persistent tingling, numbness, and severe pain in his right arm and forearm. He had also developed bluish discolouration in the nail b eds of 3–4 fingers. The patient was under the supervision of Dr. Arijit Ghosh, who, along with the multidisciplinary team, initiated an emergency diagnostic evaluation. Initial cardiac evaluation, including an ECG and Troponin I test, revealed normal findings, ruling out an acute cardiac event. An echocardiogram was also performed but did not show a conclusive diagnosis. Considering differential diagnoses such as median nerve compression and carpal tunnel syndrome (a condition caused by compression of the median nerve as it passes through a narrow passageway in the wrist called the carpal tunnel), the team administered IV paracetamol, but the patient experienced little to no pain relief.



Considering the critical nature of the case, Dr. Anindya Sundar Sarkar urgently advised a CT angiogram to assess the upper limb arterial circulation. The imaging showed a 60–70% narrowing progressing to complete blockage of the right subclavian artery (a major blood vessel that supplies blood to the right arm, shoulder and parts of the upper chest and neck), confirming a sudden blockage of blood flow to the arm. The patient was immediately taken up by the Vascular Surgery team for an emergency right subclavian thrombectomy. Thrombectomy was performed on the first day itself to remove the clot and salvage the limb, with blood circulation subsequently restored through the subclavian, axillary and brachial arteries. The exceptionally swift intervention played a crucial role in preventing permanent damage and ensuring the patients successful recovery.



Speaking about the complexity of the case, Dr. Anindya Sundar Sarkar said, “This was an extremely challenging case because the patient presented with symptoms that easily mimicked cardiac or neurological conditions, which could have delayed the true diagnosis. Managing an acute arterial blockage in such a patient requires not only rapid decision-making but also seamless coordination across multiple specialties. When initial cardiac tests came back normal, time became the single most important factor. Early recognition of symptoms, relentless tracking of differential diagnoses, and urgent CT angiography helped us prevent what could have been a catastrophic outcome. Cases like these highlight the importance of advanced emergency-ready centres and multidisciplinary expertise in saving limbs and preserving quality of life.”



The successful outcome was made possible by the seamless coordination between the Emergency, Cardiology and Vascular Surgery teams at Manipal Hospital Broadway, enabling rapid diagnosis and timely intervention at a critical juncture. The case highlights how vascular emergencies can present with symptoms that mimic more common cardiac or neurological conditions, making early clinical suspicion, timely vascular imaging and prompt surgical intervention crucial to preventing irreversible limb damage and ensuring the best possible outcome for the patient.