Manick Bhardwaj, MD; Richard Goldweit, MD; Jay Erlebacher, MD; Massoud Kashani, MD; David Levin, MD; George Leber, MD
Bhardwaj M, Goldweit R, Erlebacher J, Kashani M, Levin D, Leber G. Tissue Plasminogen Activator and Cholesterol Crystal Embolization. Ann Intern Med. 1989;111:687-688. doi: 10.7326/0003-4819-111-8-687
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Published: Ann Intern Med. 1989;111(8):687-688.
To the Editor: Cholesterol crystal embolization has been seen frequently in patients who undergo angiographic procedures after thrombolytic therapy (1). We describe a patient whose cholesterol crystal embolization occurred spontaneously after recombinant tissue-type plasminogen activator thrombolysis without an antecedent invasive vascular procedure. A 62-year-old woman with a history of hypertension and hypercholesterolemia presented with 2 hours of chest pain and electrocardiographic changes indicating acute inferior myocardial infarction. She had no history of angiography or recent surgical procedures. At initial examination there was no skin rash. Peripheral pulses were normal, but a systolic bruit was heard just below the umbilicus. She
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