Acute coronary occlusion and in-stent thrombosis in a patient with essential thrombocythemia

Turgut, Tansel; Harjai, Kishore J.; Edupuganti, Ravindra; Cole, John T.; Jenkins, J. Stephen; Ramee, Stephen R.; Collins, Tyrone J.

doi:10.1002/(sici)1097-0304(199812)45:4<428::aid-ccd19>3.0.co;2-e

Cited by 21 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tefferi et al17) reported that major thrombotic complications, such as cerebral ischemic attack and acute coronary syndrome, occurred in 7% of ET patients. Cases of acute coronary syndrome with ET were reported by some authors,18-20) but our experience of VLST associated with ET was unique.…”

Section: Discussionmentioning

confidence: 78%

Very Late Stent Thrombosis in a Drug-Eluting Stent due to Interruption of Anti-Platelet Agents in Patients With Acute Myocardial Infarction and Thrombocytosis

et al. 2011

View full text Add to dashboard Cite

Stent thrombosis is a fatal complication in patients who have undergone percutaneous coronary intervention, and discontinuation of anti-platelet agent is a major risk factor of stent thrombosis. We report a rare case of very late stent thrombosis (VLST) following discontinuation of anti-platelet agents in a patient who experienced acute myocardial infarction and essential thrombocytosis. She had undergone implantation of a drug eluting stent (DES) and a bare metal stent (BMS) two and half years prior to her presentation. VLST developed in DES, not in BMS, following interruption of anti-platelet therapy.

show abstract

Section: Discussionmentioning

confidence: 78%

Very Late Stent Thrombosis in a Drug-Eluting Stent due to Interruption of Anti-Platelet Agents in Patients With Acute Myocardial Infarction and Thrombocytosis

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Although ET may cause vascular thrombosis and tissue ischemia, coronary artery involvement, with acute coronary syndrome, is very uncommon. Only about 21 such cases have been described in the medical literature, and four of these cases were reported to be treated with coronary angioplasty and stent placement3, 4, 7, 8).…”

Section: Discussionmentioning

confidence: 99%

“…These patients suffered from the complication of stent thrombosis after the procedure7, 8). The other two had unstable angina as a complication of ET and they received percutaneous angioplasty with stent placement along with cytostatic and antiplatelet therapy3, 4).…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Intervention after Cytostatics Treatment in Unstable Angina Patient with Essential Thrombocythemia. A Case Report and Literature Review

Chang¹,

Shim²,

Cheong

et al. 2006

Korean J Intern Med

View full text Add to dashboard Cite

Essential thrombocythemia (ET) is a clonal disorder of myeloid stem cells that causes thrombocytosis. As a result, ET can lead to vascular thrombosis and tissue ischemia; the association of coronary artery abnormalities such as myocardial infarction or unstable angina is rare. Here we describe a 45-year-old male patient with essential thrombocythemia who presented with unstable angina. Elective coronary angiography showed total occlusion of mid right coronary artery and mid left anterior descending coronary artery. ET was confirmed by a bone marrow biopsy; treatment was started with antiplatelet therapy including aspirin and clopidogrel along with cytostatic therapy with hydroxyurea and anagrelide. After the initiation of the treatment, the platelet count decreased to 20×104/µL. In addition, percutaneous coronary angioplasty was successfully performed with stent placement at the right coronary artery without hemorrhagic or thrombotic complications.

show abstract

“…Essential thrombocytosis can be complicated by both thrombotic and/or hemorrhagic sequelae. De Novo coronary thrombus is rare, but has been described in literature [2][3][4][5][6][7][8][9][10][11]. We present a patient with ET and an unusual presentation of inferior myocardial infarction secondary to paradoxical embolus through a patent foramen ovale (PFO) in the setting of acute pulmonary embolism.…”

Section: Introductionmentioning

confidence: 99%

ST-elevation myocardial infarction secondary to paradoxical coronary emboli in a patient with massive pulmonary embolism and essential thrombocytosis: A case report

Almehmadi¹,

Mehdar²,

Sridhar³

et al. 2015

IJCRI

View full text Add to dashboard Cite

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Essential thrombocytosis (ET) is a myeloproliferative disorder with higher incidence of thrombotic events. To our knowledge, we present the first case of ST-segment elevation myocardial infarction (STEMI) secondary to paradoxical right coronary artery (RCA) embolus through a patent foramen ovale (PFO) in a patient with essential thrombocytosis and pulmonary embolus. Case Report: A 67-year old female with a history of ET presented to the emergency room with dyspnea. Physical examination revealed an elevated JVP, an S1Q3T3 pattern on her presenting ECG, and an elevated D-dimer. V/Q scan showed a high probability for pulmonary embolism as well as unusual evidence of right-to-left cardiac shunting. After starting low molecular weight heparin, she developed new-onset chest pain and her ECG showed ST-elevation in the inferior leads. Emergency left and right heart catheterization showed an acutely occluded RCA with heavy thrombus burden. This was managed successfully with thrombus aspiration only. Massive bilateral pulmonary embolism was seen on thoracic computed tomography (CT) scan, which was managed by systemic thrombolysis. A Transesophageal echocardiogram was performed, which confirmed a patent PFO with right-to-left shunting. The patient was treated medically with dual antiplatelets, anticoagulation with heparin and hydroxyurea. Given the degree of thrombotic burden PFO closure was not performed and the patient was managed conservatively with lifelong anticoagulation. The patient has been followed closely, and three years post-event, she has done remarkably well on warfarin with no evidence of further thromboembolism. Conclusion:We describe the first case of paradoxical coronary artery embolism through a PFO in a patient with ET and massive PE. Our patient was managed conservatively on oral anticoagulation without further thromboembolic events at three years post-event.

show abstract

Acute coronary occlusion and in-stent thrombosis in a patient with essential thrombocythemia

Cited by 21 publications

References 29 publications

Very Late Stent Thrombosis in a Drug-Eluting Stent due to Interruption of Anti-Platelet Agents in Patients With Acute Myocardial Infarction and Thrombocytosis

Very Late Stent Thrombosis in a Drug-Eluting Stent due to Interruption of Anti-Platelet Agents in Patients With Acute Myocardial Infarction and Thrombocytosis

Coronary Artery Intervention after Cytostatics Treatment in Unstable Angina Patient with Essential Thrombocythemia. A Case Report and Literature Review

ST-elevation myocardial infarction secondary to paradoxical coronary emboli in a patient with massive pulmonary embolism and essential thrombocytosis: A case report

Contact Info

Product

Resources

About