Cholesterol Embolization Syndrome From Penetrating Aortic Ulcer.
| Autor: | Nickol J; Internal Medicine, Magnolia Regional Health Center, Corinth, USA., Richards T; Cardiology, Magnolia Regional Health Center, Corinth, USA., Mullins J; Internal Medicine, Magnolia Regional Health Center, Corinth, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2020 Jun 17; Vol. 12 (6), pp. e8670. Date of Electronic Publication: 2020 Jun 17. |
| DOI: | 10.7759/cureus.8670 |
| Abstrakt: | Penetrating aortic ulcer (PAU) is an important, albeit, rarer cause of embolization to internal organs and distal extremities. Embolization occurs as a result of the disruption of cholesterol deposition in the wall of the aorta by a PAU. The classic presentation of cholesterol embolization syndrome (CES) includes pain, pallor, poikilothermia, paresthesia, and paralysis with intact pulses. The patient will classically have livedo reticularis or "blue toes." We present a case of a patient who presented to the emergency department with the complaint of a painful, blue toe. The patient had intact distal pulses on exam with the distal 2/3 of the first toe having a markedly blue/black color with livedo reticularis spreading proximally on the other 1/3 of the toe. CT angiogram with runoff to the lower extremities revealed a 3.6-cm infrarenal abdominal aortic aneurysm with a 5-mm penetrating aortic ulcer with a three-vessel runoff to the distal lower extremities. The diagnosis of CES secondary to a PAU was made. While thrombotic embolization from PAU causing acute limb ischemia is less common, it is well described. In contrast, cholesterol embolization from PAU remains a rare phenomenon without adequate treatment options. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, Nickol et al.) |
| Databáze: | MEDLINE |
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