Fursevich Dzmitry, Zuchowski Colin, Limback Joseph, Kendall Melissa, Ramirez Ashley, Fanaian Naim, Burt Jeremy
Florida Hospital, Orlando, FL, USA.
Case Rep Cardiol. 2017;2017:7298347. doi: 10.1155/2017/7298347. Epub 2017 Aug 7.
We report a case of a 39-year-old male who presented to the emergency department with acute chest pain while being in remission from T-cell acute lymphoblastic leukemia (T-ALL). Cardiac markers were elevated and EKG revealed ischemic changes compatible with acute myocardial ischemia. Coronary computed tomography angiography (CCTA) showed calcium-free coronary arteries and soft tissue myocardial infiltration suggestive of cardiac leukemia. A bone marrow biopsy confirmed recurrence of T-ALL, and patient was successfully treated with chemotherapy. We discuss the prospective diagnosis of myopericardial leukemic involvement and the role of CCTA in diagnosis and perform a literature review.
我们报告一例39岁男性,该患者在T细胞急性淋巴细胞白血病(T-ALL)缓解期因急性胸痛就诊于急诊科。心脏标志物升高,心电图显示与急性心肌缺血相符的缺血性改变。冠状动脉计算机断层扫描血管造影(CCTA)显示冠状动脉无钙化,软组织心肌浸润提示心脏白血病。骨髓活检证实T-ALL复发,患者接受化疗后成功治愈。我们讨论了心肌心包白血病累及的前瞻性诊断以及CCTA在诊断中的作用,并进行了文献综述。