Introduction RBCs are damaged in systemic circulation due to force delivered in large caliber vessels or the heart itself Associated conditions mechanical heart valves calcified or stenotic heart valves most commonly aortic valve Presentation Symptoms anemia fatigue jaundice pallor shortness of breath Evaluation Labs decreased Hgb increased reticulocyte % increased unconjugated bilirubin increased LDH decreased haptoglobin Blood smear: schistocytes (helmet cells) due to shearing mechanical destruction burr cells (echinocytes) Normal platelet count Treatment Pharmacologic chronic blood transfusions indicated for anemic episodes Operative repair of defective valve OR replacement of previous prosthetic valve indicated in severe cases
QUESTIONS 1 of 2 1 2 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.HE.13.124) A 62-year-old woman is evaluated for fatigue 6 months after placement of a mechanical valve due to aortic stenosis. She does not drink alcohol or smoke cigarettes. A complete blood count reports hemoglobin of 9.5 g/L and a reticulocyte percentage of 5.8%. Platelet and leukocyte counts are within their normal ranges. The patient’s physician suspects traumatic hemolysis from the patient’s mechanical valve as the cause of her anemia. Which of the following peripheral blood smear findings would most support this diagnosis? QID: 101434 Type & Select Correct Answer 1 Bite cells and Heinz bodies 10% (27/282) 2 Sickle cells and target cells 2% (7/282) 3 RBC fragments and schistocytes 84% (238/282) 4 Round macrocytes and target cells 1% (3/282) 5 Macrocytes and hypersegmented neutrophils 0% (1/282) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic