Essential Thrombocythemia-Related Acute ST-Segment Elevation Myocardial Infarction

Daya, Samantapudi K.; Gowda, Ramesh M.; Landis, William A.; Khan, Ijaz A.

doi:10.1177/000331970405500312

Cited by 27 publications

(24 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3,4] Therefore, it is essential to detect and treat it before complications occur. Prophylactic and therapeutic agents are well defined for this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Arterial and venous thrombosis due to primary thrombocytosis after splenectomy

Karaca¹

2014

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

“…[3,4] Therefore, it is essential to detect and treat it before complications occur. Prophylactic and therapeutic agents are well defined for this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Arterial and venous thrombosis due to primary thrombocytosis after splenectomy

Karaca¹

2014

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

“…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

“…In unstable cardiac patients with extremely high platelet counts who require urgent surgery, plateletpheresis (uncommonly, but more accurately, called thrombocytapheresis) was found to be extremely effective in reducing counts and symptoms. 9 The importance of reducing platelets preoperatively was well illustrated by the cases of Daya and colleagues 10 and Momiyama and coworkers, 11 whose patients successfully underwent urgent coronary surgery before receiving a platelet-lowering agent. Their patients experienced postoperative sequelae: pulmonary embolism, myocardial infarction, and cerebral infarction.…”

mentioning

confidence: 99%

“…However, 31% of patients developed postoperative sequelae in the form of coronary artery thrombosis, tamponade, pulmonary embolism, or myocardial and cerebral infarction. 10,11,13 The application of off-pump CPB among these patients has apparently been limited to 2 instances. 12,22 Although the surgery itself was satisfactory, one patient died early of an unexplained postoperative cardiac arrest.…”

mentioning

confidence: 99%

Off-Pump Myocardial Revascularization in a High-Risk Patient with Essential Thrombocythemia

Darwazah¹,

Madi²,

Zagha³

et al. 2014

Texas Heart Institute Journal

View full text Add to dashboard Cite

Essential thrombocythemia is a rare type of myeloproliferative disorder. Cerebral, myocardial, and peripheral E ssential thrombocythemia is a chronic myeloproliferative disease characterized by persistent elevation of platelet count.1,2 Patients might remain asymptomatic; however, most have a tendency toward thrombosis and to a lesser extent toward hemorrhage affecting the cerebral, coronary, and peripheral vessels.Cardiovascular sequelae among these patients vary from 4% to 21%. 1 The incidence of coronary artery disease can reach 9.4%, and this is accompanied by a high incidence of acute myocardial infarction. 2 We present the case of an elderly man with manifestations of essential thrombocythemia. Both medical and surgical management are discussed. Case ReportIn September 2012, a 71-year-old heavy smoker presented at another hospital for evaluation of dyspnea and dizziness. During the preceding 2 months, this man had been admitted to various hospitals with dyspnea, wheezy chest, and peripheral edema. He was told that all his symptoms were related to smoking, and he was treated for emphysema.During routine laboratory investigations, a high platelet count of 1,486 ×10 3 /µL was found, with a hemoglobin level of 14 g/dL, a hematocrit of 37.9%, a mean corpuscular volume of 82 f L, and a white blood count of 8.4 K/µL. Results of other blood tests were normal.The diagnosis of essential thrombocythemia was confirmed by bone marrow aspirate, which showed an increased number of megakaryocytes; other hemopoietic elements were normal (Fig. 1). Reverse transcription polymerase chain reaction analysis for the Philadelphia chromosome was negative. The patient was given hydroxycarbamide (2 g/d), aspirin (100 mg/d), clopidogrel (75 mg/d), a diuretic, and a bronchodilator. During the course of treatment, he had a syncopal attack, which lasted for a few minutes.The patient was referred to our hospital after a carotid artery duplex scan yielded normal results and a brain magnetic resonance image showed signs of senile atrophic changes, together with bilateral small vascular ischemic changes (Fig. 2).On admission, the patient was slightly tachypneic. His blood pressure was normal, and he had a regular pulse of 78 beats/min. His oxygen saturation on room air was 88%.Chest examination showed a bilateral decrease in air entry. Scattered wheezes were heard all over the chest, together with fine crepitations along the lung bases. Cardiac examination revealed a soft pansystolic murmur over the mitral area, extending to the axilla. There was mild bilateral peripheral edema and painful light-blue coloration

show abstract

Essential Thrombocythemia-Related Acute ST-Segment Elevation Myocardial Infarction

Cited by 27 publications

References 12 publications

Arterial and venous thrombosis due to primary thrombocytosis after splenectomy

Arterial and venous thrombosis due to primary thrombocytosis after splenectomy

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

Off-Pump Myocardial Revascularization in a High-Risk Patient with Essential Thrombocythemia

Contact Info

Product

Resources

About