Progressive acute kidney injury following myocardial infarction: cholesterol embolisation

Abstract

Acute kidney injury following acute coronary event can occur from multiple factors, including secondary to volume depletion, poor perfusion because of cardiac dysfunction, secondary to medications such as angiotensin converting enzyme inhibitors or angiotensin receptor blockers or because of aggressive diuretics or use of contrast agents. Atheroembolism (cholesterol embolisation) often occurs following an intervention, such as angiography or revascularisation procedure. An uncommon presentation of atheroembolic renal disease that likely was precipitated by the use of thrombolytics and/or anticoagulation is discussed.

Figure 1

Several empty acicular spaces (biconcave parallel slits) can be seen; atheroemboli lodged in a vessel with occluded lumen. A. Hematoxylin and eosin (H&E) stain ×10; B. Elastic trichrome stain ×10.