Avtor/Urednik		Kariž, Stojan; Grom, Igor; Marušič, Tamara
Naslov		Sindrom holesterolnih embolizmov - zaplet trombolitičnega zdravljenja pri bolniku z akutnim miokardnim infarktom
Prevedeni naslov		Cholesterol embolization syndrome - a complication of thrombolytic therapy in a patient with acute myocardial infarction
Tip		članek
Vir		In: Bručan A, Gričar M, Fink A, et al, editors. Urgentna medicina: izbrana poglavja 7. Zbornik 8. mednarodni simpozij o urgentni medicini; 2001 jun 13-16; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2001
Obseg		str. 289-93
Jezik		slo
Abstrakt		Cholesterol embolization syndrome is a rare complication of thrombolytic treatment for acute myocardial infarction. It refers to the occlusion of small arteries by cholesterol crystals dislodged from ruptured atheromatous plaques in proximal major arteries, leading to distal ischemic lesions and necrosis of affected organs. The skin, skeletal muscles, kidneys, spleen, intestines, and pancreas are most frequently affected. The clinical picture is nonspecific and varied and thereby difficult to diagnose. The most frequent clinical signs and symptoms are pain in the abdomen and lower extremities, livedo reticularis, ischemia of the toes with subsequent necrosis and renal failure. The authors report a case of a 71-year-old male patient with an acute inferior myocardial infarction who received thrombolytic therapy with streptokinase. Two hours later he complained of severe abdominal and lower limb pain. A blue-red mottling of the skin over the lower part of the body with cyanosis of the toes appeared. An assumption of an acute vascular complication after thrombolytic therapy was made. Echocardiography, abdominal ultrasonography and computed tomographic scanning of the chest and abdomen were nondiagnostic. The patient was transferred to CIIM to Ljubljana for further diagriostic evaluation. CT angiography ruled out any significant pathology of thoracic and abdominal aorta, so as bleeding from any of its branches. The acute complication of thrombolytic therapy was assigned to likely atheroembolization from an atherosclerotic plaque in the aorta. The likelihood of cholesterol embolism was confirmed by further clinical progress (hematochezia, renal failure, and necrosis of the right 3rd, 4th, and 5th toe with amputation).
Deskriptorji		THROMBOLYTIC THERAPY EMBOLISM, CHOLESTEROL MYOCARDIAL INFARCTION AGED