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Atheroembolism: Clinical Scenario
• 65 yo with CAD or ASO started on
heparin/coumadin for PE (no cardiac
shunts)
– Painful Great toe with worsening
hypertension and fevers 3 days later
• Why? Only received heparin…
• Anticoagulation removes fibrin off/out of
ASO plaque destabilizing it and/or bleed
into plaque = shower atheroemboli
• Eosinophilia and/or elevated ESR help in
addition H&P (r/o other embolic source)