Splenic Infarction with Myocardial Injury in a Diabetic Patient: A Case Report

Abstract

Splenic infarction (SI) is an uncommon complication of type 2 diabetes (T2D). Diabetes predisposes individuals to blood vessel abnormalities, such as atherosclerosis or thrombosis, increasing the risk of vessel occlusion and subsequent tissue infarction. If the diabetic patient has other serious diseases, such as a severe pneumonia infection and acute cardiac infarction, SI incidence may go unrecognized, making it challenging for physicians to identify. This case report discussed an 80-year-old hospitalized diabetic woman with a history of chronic bronchitis and 20 years of T2D who suffered an SI. The patient was at elevated risk for thrombosis of atrial fibrillation, manifested as an embolism of the spleen characterized by a high concentration of white blood cells. This patient also demonstrated a rapid increase in cardiac biomarkers troponin I, suggesting acute myocardial infarction (AMI) and increased amylase, which could not preclude the concern about the existence of acute pancreatitis. Abdominal CT displayed the calcification of only the splenic and other arteries, and low-density shadows were observed at the center portion of the spleen. This case demonstrated the significant occurrence of thrombotic complications in various blood vessels of multiple organs in T2D patients. Thus, clinicians should be aware of the possibility of simultaneous acute vascular infarction of several organs in diabetic patients with prior vascular constriction.

Splenic Infarct Masquerading as Myocardial Infarction

“…Concurrent cardiac, splenic, and renal infarcts have been documented in a patient with COVID-19 owing to the hypercoagulable state associated with the virus [ 10 ]. Another case report described a potential thromboembolic event causing splenic infarction and myocardial injury in a patient with underlying atrial fibrillation and diabetes as the risk factors [ 11 ]. To the best of our knowledge, this is the first reported case of concomitant splenic and myocardial infarction in a patient without hypercoagulable disorder, atrial fibrillation, or a positive COVID-19 result.…”