Morning Report Unknown

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Morning Report Unknown 1
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Whats the diagnosis, what do you need to do??

• Your GT3 calls you to the bedside to show you the
  following finding on a patients foot.
• The patient was admitted 24 hours before with an
  acute MI and underwent successful PCI in the cath
  lab
• The medical student happily notes the foot is
  warm and the pulses are full.

3
Cholesterol Embolism (Blue Toe Syndrome)

• Atheroembolic disease that may follow
  intraarterial procedures
• Aortic aneurysm
• Catheterization
• Emboli often small and do not obstruct major
  vessels pulses usually remain intact
• Severe ischemia may result with larger emboli
• May be confirmed by biposy
• Difficult to treat
• Antiplatelet agents
• Surgical bypass if possible

Frozen section of toe punch biopsy showing
dissolved cholesterol crystal streaks within a
small vessel