Microangiopathy

When red cells undergo mechanical damage, pieces of them appear in the peripheral blood, and these are known as 'schistocytes' or red cell fragments. An hemolytic anemia may result if the process is severe enough. Perhaps the commonest cause is a mechanical heart valve, which has developed abnormal function, but you should try and remember that hemolytic uremic syndrome (HUS), and thrombotic thrombocytopenic purpura (TTP) can do the same thing.