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Microembolization from atheroembolic disease or aneurysm. A case study
B D Caldwell1, V S Marrochello
1Department of Podiatric Medicine, Ohio College of Podiatric Medicine, Cleveland, USA.
Insights
Blue toe syndrome, often caused by atheroembolism or aneurysm, is frequently misdiagnosed. Early diagnosis using vascular testing is crucial as it can be limb- or life-threatening.
Area of Science:
- Vascular Medicine
- Cardiology
- Dermatology
Background:
- Digital cyanosis, or blue toe syndrome, has diverse causes including trauma and connective tissue disease.
- Atheroembolic disease and aneurysms are common, yet often misdiagnosed, causes of blue toe syndrome.
- Palpable pedal pulses can mislead clinicians away from diagnosing underlying vascular pathology.
Abstract:
Cyanosis of the digits may have several etiologies ranging from trauma to connective tissue disease; however, the most common cause of the so-called blue toe syndrome is atheroembolic disease or aneurysm and is frequently misdiagnosed on initial presentation. Pedal pulses are often palpable which may misdirect the physician from a diagnosis of vascular pathology. Furthermore, the proximal source of embolic shower may be far from the sight of symptoms. Noninvasive vascular testing, peripheral angiography, abdominal and popliteal ultrasonography, and echocardiography are all techniques that may be beneficial in discovering the origin of emboli. Atheroembolisms and aneurysms can be limb-threatening or life-threatening and hence early diagnosis is imperative.