Monday, September 14, 2009


This is an incidental finding in a patient with a ball-cage prosthetic valve for a remote history of refractory endocarditis.

Challenge: Why this finding?

Related Questions:
1. What do you see on the smear?

Image shown under fair use.


Stephanie said...

hemolytic anemia, schistocytes

Alex said...

schistocytes 2/2 the valve. sort of like MAHA

Craig Chen said...

yes sort of like mahahaha :)

The smear shows schistocytes. Hemolytic anemia from mechanical damage can be seen with leaky prosthetic heart valves due to rapid acceleration and deceleration of the regurgitant jet and/or high peak shear rates. Hemolysis is most often mild and subclinical. Treatment is oral iron, blood transfusion, or reoperation.

Sources: UpToDate;