Cholesterol emboli syndrome causes: Difference between revisions
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==Overview== | ==Overview== | ||
==Causes== | ==Causes== | ||
It is relatively unusual (25%) for cholesterol emboli to occur spontaneously; this usually happens in people with severe [[atherosclerosis]] of the large arteries such as the [[aorta]]. In the other 75% it is a complication of medical procedures involving the blood vessels, such as [[vascular surgery]] or [[angiography]]. In [[coronary catheterization]], for instance, the incidence is 1.4%.<ref name=Fukumoto>{{cite journal |author=Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A |title=The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study |journal=J. Am. Coll. Cardiol. |volume=42 |issue=2 |pages=211–6 |year=2003 |month=July |pmid=12875753 |doi=10.1016/S0735-1097(03)00579-5 | url=http://linkinghub.elsevier.com/retrieve/pii/S0735109703005795}}</ref> Furthermore, cholesterol embolism may develop after the commencement of [[anticoagulant]]s or [[thrombolysis|thrombolytic]] medication that decrease blood clotting or dissolve blood clots, respectively. They probably lead to cholesterol emboli by removing blood clots that cover up a damaged atherosclerotic plaque; cholesterol-rich debris can then enter the bloodsteam. | It is relatively unusual (25%) for cholesterol emboli to occur spontaneously; this usually happens in people with severe [[atherosclerosis]] of the large arteries such as the [[aorta]]. In the other 75% it is a complication of medical procedures involving the blood vessels, such as [[vascular surgery]] or [[angiography]]. In [[coronary catheterization]], for instance, the incidence is 1.4%.<ref name=Fukumoto>{{cite journal |author=Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A |title=The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study |journal=J. Am. Coll. Cardiol. |volume=42 |issue=2 |pages=211–6 |year=2003 |month=July |pmid=12875753 |doi=10.1016/S0735-1097(03)00579-5 | url=http://linkinghub.elsevier.com/retrieve/pii/S0735109703005795}}</ref> Furthermore, cholesterol embolism may develop after the commencement of [[anticoagulant]]s or [[thrombolysis|thrombolytic]] medication that decrease blood clotting or dissolve blood clots, respectively. They probably lead to cholesterol emboli by removing blood clots that cover up a damaged atherosclerotic plaque; cholesterol-rich debris can then enter the bloodsteam. | ||
Findings on general investigations (such as [[blood test]]s) are not specific for cholesterol embolism, which makes diagnosis difficult. The main problem is the distinction between cholesterol embolism and [[vasculitis]] (inflammation of the small blood vessels), which may cause very similar symptoms - especially the skin findings and the kidney dysfunction. | Findings on general investigations (such as [[blood test]]s) are not specific for cholesterol embolism, which makes diagnosis difficult. The main problem is the distinction between cholesterol embolism and [[vasculitis]] (inflammation of the small blood vessels), which may cause very similar symptoms - especially the skin findings and the kidney dysfunction. Worsening kidney function after an angiogram may also be attributed to kidney damage by substances used during the procedure ([[Radiocontrast#Contrast-induced nephropathy|contrast nephropathy]]). Other causes that may lead to similar symptoms include [[acute tubular necrosis|ischemic renal failure]] (kidney dysfunction due to an interrupted blood supply), a group of diseases known as [[microangiopathic hemolytic anemia|thrombotic microangiopathies]] and [[endocarditis]] (infection of the [[heart valve]]s with small clumps of infected tissue embolizing through the body). | ||
==References== | ==References== | ||
Revision as of 14:27, 27 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
It is relatively unusual (25%) for cholesterol emboli to occur spontaneously; this usually happens in people with severe atherosclerosis of the large arteries such as the aorta. In the other 75% it is a complication of medical procedures involving the blood vessels, such as vascular surgery or angiography. In coronary catheterization, for instance, the incidence is 1.4%.[1] Furthermore, cholesterol embolism may develop after the commencement of anticoagulants or thrombolytic medication that decrease blood clotting or dissolve blood clots, respectively. They probably lead to cholesterol emboli by removing blood clots that cover up a damaged atherosclerotic plaque; cholesterol-rich debris can then enter the bloodsteam.
Findings on general investigations (such as blood tests) are not specific for cholesterol embolism, which makes diagnosis difficult. The main problem is the distinction between cholesterol embolism and vasculitis (inflammation of the small blood vessels), which may cause very similar symptoms - especially the skin findings and the kidney dysfunction. Worsening kidney function after an angiogram may also be attributed to kidney damage by substances used during the procedure (contrast nephropathy). Other causes that may lead to similar symptoms include ischemic renal failure (kidney dysfunction due to an interrupted blood supply), a group of diseases known as thrombotic microangiopathies and endocarditis (infection of the heart valves with small clumps of infected tissue embolizing through the body).
References
- ↑ Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A (2003). "The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study". J. Am. Coll. Cardiol. 42 (2): 211–6. doi:10.1016/S0735-1097(03)00579-5. PMID 12875753. Unknown parameter
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