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Related Experiment Videos

Relapsing digital ulcers.

F Bauwens1, D Duprez, D L Clement

  • 1University Hospital, Gent, Belgium.

Acta Cardiologica
|January 1, 1989
PubMed
Summary
This summary is machine-generated.

Cholesterol embolization syndrome, presenting as purple toes and digital ulcers, may be precipitated by coumarin therapy in patients with atrial fibrillation. This rare condition involves cholesterol crystals lodging in small arteries, potentially linked to aortic mural thrombus.

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Area of Science:

  • Vascular Medicine
  • Cardiology
  • Nephrology

Background:

  • Cholesterol embolization syndrome (CES) is a rare systemic complication.
  • It often presents with characteristic skin manifestations like digital ulcers and cyanosis.
  • Aortic atherosclerosis and anticoagulation therapy are recognized risk factors.

Observation:

  • A 72-year-old male developed relapsing digital ulcers and cyanosis ('purple toes').
  • Symptoms appeared 5 months after initiating coumarin for atrial fibrillation and low output failure.
  • Massive abdominal aortic mural thrombosis was identified, alongside progressive renal failure and eosinophilia.

Findings:

  • The patient's presentation strongly suggested cholesterol embolization from an ulcerated atherosclerotic plaque within the aortic mural thrombus.

Related Experiment Videos

  • While the exact role of coumarin is speculative, numerous reports suggest it may precipitate CES.
  • The clinical spectrum of CES is broad, extending beyond typical presentations.

    • Implications:

    • This case highlights the potential link between coumarin therapy and CES in patients with significant aortic disease.
    • Early recognition and identification of the embolic source are crucial for management.
    • Further research is needed to clarify the precise mechanisms and risk factors associated with coumarin-induced CES.