A 73-year-old ex-smoker with a history of hyperlipemia and triple-by-coronary pacemaker surgery 11 years earlier was admitted to the hospital with dyspnea and angina on mild exertion for one month.
For this reason, coronary angiography was performed by cardiac catheterization, which showed a coronary disease of three vessels with non-revascularizable obstruction of the saphenous vein graft to marginal obtuse.
Prior to the procedure, the patient was under antiplatelet therapy and had moderate renal insufficiency (creatinine clearance mg/dl) that did not contraindicate the study.
From the time the patient presented a general syndrome with anorexia and anorexia. The laboratory analysis performed two weeks later showed worsening of renal function, with creatinine 7.5 mg/dlES and acute cardiac catheterization with suspected asthenia C.
Due to the progressive increase in creatinine, he required hemodialysis, and as new signs appeared purple spots in the lateral area of the foot (livid reticularis) whose biopsy did not reveal cholesterol emboli.
Cholesterol deficiency was observed in four branches at 40 days, for fundus examination, located in the left eye and visual acuity (VA) was 0.8 in both eyes, intraocular pressure (IOP) was 13 mm.
Subsequently, the patient presented heart failure, accompanied by signs and symptoms of acute peripheral ischemia, worsening of the general condition and progressive obtundation until his death 73 days after the coronary angiography.
At necropsy numerous cholesterol emboli were observed in vascular structures of thyroid, pancreas, heart, spleen, liver and kidneys.
