Cholesterol emboli syndrome--a rare complication of cardiac catheterization

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• A 57-year-old male with hypertension, diabetes, and dyslipidemia presented with exertional angina.
• The patient had undergone coronary artery bypass surgery one year prior to presentation.

Observation:

• Left heart catheterization with graft study revealed critical native triple vessel disease.
• Patent arterial graft to the left anterior descending artery was noted, alongside occluded venous grafts to the obtuse marginal and right coronary arteries.

Findings:

• The cardiac catheterization procedure was complicated by catheter-induced dissection of the ascending aorta.
• Three days post-procedure, the patient developed cholesterol emboli syndrome.

Implications:

• This case underscores the potential for serious vascular complications, including aortic dissection and cholesterol emboli syndrome, following invasive cardiac procedures.
• Prompt recognition and symptomatic management are crucial for patients developing cholesterol emboli syndrome after interventions.
• The findings emphasize the importance of careful technique during cardiac catheterization, especially in patients with complex coronary artery disease and prior revascularization.