ABSTRACT
The short history and the presence of four of the ‘six P’s’ (pulseless, pale, pain, perishingly cold) suggest the most likely diagnosis is acute lower limb ischaemia. This limb should still be considered salvageable at this point, and thus amputation is not appropriate; he will most likely need
surgical embolectomy. His AF is the most likely cause of his emboli, and hence he will need to be commenced on warfarin post-operatively.
