© 2003 by BMJ Publishing Group & British Cardiac Society
CASE REPORT
Trash feet after coronary angiography
Department of Vascular Surgery, King George Hospital, Essex, UK
Correspondence to:
Correspondence to:
Mr A M Khan, 89 Bank Street, Valley Stream, Long Island, NY 11580, USA;
dramirkhan{at}hotmail.com
Cholesterol crystal embolisation is a frequently underdiagnosed condition. While coronary catheterisation is safe and commonly performed, the reported patient developed very painful trash feet after undergoing this routine procedure. Ulceration and gangrene occurred after catheter manipulation during cardiac angiography, which caused occlusion of the small arteries in his feet. The triad of pain, livedo reticularis, and intact peripheral pulses is pathognomonic for cholesterol embolisation. The prognosis depends on the extent of the systemic disease and a high rate of mortality (75–80%) is observed. Prognosis is poor and the treatment is only supportive. It is suggested that while cardiac catheterisation is largely safe and a very commonly performed procedure, it can still lead to complications with serious side effects and can even prove fatal.
Keywords: cholesterol crystal embolisation; coronary angiography; gangrene
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Heart 2003 89: 489.
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