Symmetrical peripheral gangrene

Two cases of symmetrical peripheral gangrene associated with intracardiac lesions are described. One had a secondary deposit from a uterine leiomyosarcoma in the wall of the right ventricle, the other had a free ball thrombus in the right atrium; there were no valvular lesions in either case. The published reports of this type of gangrene indicate that it may result from (1) va sospastic conditions, (2) small vessel obstruction, or (3) conditions producing a very low cardiac output. The two patients reported are unusual examples of the last.