Yamaguchi M, Murata R, Mizutani T, Kawamura Y, Ueda M
Department of Immunology and Hematology, Ishikawa Prefectural Central Hospital.
Rinsho Ketsueki. 2001 Sep;42(9):716-8.
A 71-year-old man with acute myelogenous leukemia (AML, M2) developed signs of chest oppression, and was diagnosed as having acute myocardial infarction (AMI). At the same time, his leukemia relapsed in association with disseminated intravascular coagulation (DIC). The patient's risk factors for AMI were hyperlipidemia, hyperglycemia, and a history of smoking. Coronary angiography showed occlusion of the circumflex branch. Percutaneous transluminal angioplasty (PTCA) was performed successfully, followed by administration of heparin. After chemotherapy, the patient's DIC improved and a second remission was attained. When elderly patients with AML show evidence of DIC, we should be aware of AMI as a possible complication. PTCA is a safe operation for such patients.
一名71岁的急性髓性白血病(AML,M2型)男性患者出现胸部压迫症状,被诊断为急性心肌梗死(AMI)。同时,他的白血病复发并伴有弥散性血管内凝血(DIC)。该患者发生AMI的危险因素为高脂血症、高血糖和吸烟史。冠状动脉造影显示回旋支闭塞。成功进行了经皮腔内血管成形术(PTCA),随后给予肝素治疗。化疗后,患者的DIC得到改善并实现了第二次缓解。当老年AML患者出现DIC证据时,我们应警惕AMI这一可能的并发症。PTCA对此类患者是一种安全的手术。