Acute Coronary Artery Thrombosis in a Patient With Non-Small Cell Lung Cancer

Lahmidi, Ismahane; Aissaoui, Hanane; Ismaili, Nabila; Elouafi, Noha

doi:10.7759/cureus.12507

Cited by 1 publication

(2 citation statements)

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“…Clinical management of chronic anticoagulation treatment should carefully assess the ischemic risk and haemorrhagic danger of each patient individually. Contemporary literature supports the notion of DOAC's safe profile in the prevention of systemic embolism, even in cases with concomitant LV thrombus [34] in the present case the decision for chronic treatment with a DOAC was amenable to existent literature data displaying antithrombotic management in patients with systematic/arterial thromboembolic events [30][31][32][33]. Regarding cancer patients, the use of DOAC's has been described mainly in the context of deep vein thrombosis and pulmonary embolism [35].…”

Section: Discussionsupporting

confidence: 69%

“…Antithrombotic treatment of patients with blood malignancies and arterial thrombosis can be challenging in daily clinical practice, while few reports in literature describe similar cases [30][31][32][33]. Clinical management of chronic anticoagulation treatment should carefully assess the ischemic risk and haemorrhagic danger of each patient individually.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac amyloidosis presenting with coronary artery embolization

Papageorgiou

Tsagalou

Baraboutis

et al. 2021

Rev. Cardiovasc. Med.

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Amyloid light-chain (AL) amyloidosis is a multisystemic disease. Among its clinical manifestations, vein and arterial thromboembolic events are included. We report the unusual case of a 57-year-old female patient with AL amyloidosis presenting with an ST segment elevation myocardial infarction due to coronary artery embolization (CE). The patient reported a history of exertional dyspnoea along with episodes of haemoptysis for the last few months. Her coronary angiography demonstrated embolization of the distal segment of the left anterior descending artery. The main findings of her cardiac ultrasound included concentric left ventricular hypertrophy, mildly impaired left ventricular systolic function, left atrium enlargement and a restrictive-like filling pattern, while her chest computed tomography (CT) demonstrated bilateral pleural effusions. Cardiac magnetic resonance imaging that was performed afterwards, indicated areas of microvascular infarction, a small apex infarct and findings compatible with possible amyloidosis, a diagnosis that was confirmed later by fat tissue biopsy. Patient was referred for an oncology consultation, started therapy with direct oral anticoagulants, angiotensin converting enzyme inhibitor, statins and anti-plasma cell therapy. She has been improving since then and has been free of cardiovascular events for a follow-up period of 12 months. Cardiologists ought to be aware of amyloidosis as a rare but possible cause of coronary embolization, while close collaboration with oncologists is required for the establishment of the correct diagnosis.

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