Zheng Shuzhan, Luo Sha, Luo Yong, Liu Dan, Zheng Wenwu, Peng Qing
Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Cardiovasc Med. 2023 Sep 13;10:1259548. doi: 10.3389/fcvm.2023.1259548. eCollection 2023.
Thrombotic complications in acute myeloid leukemia (AML) are uncommon due to coagulation dysfunction and thrombocytopenia. We report a unique case of AML presenting as concomitant pulmonary embolism and atypical acute myocardial infarction. A 67-year-old male experienced persistent bilateral chest pain. Despite an unremarkable electrocardiogram, elevated D-dimer and mildly increased troponin T levels prompted further investigation, leading to the diagnosis of simultaneous pulmonary embolism and acute myocardial infarction. The patient underwent percutaneous coronary intervention and received triple antithrombotic therapy. However, antithrombotic therapy was discontinued following a sharp decline in hemoglobin and platelet counts, and the patient subsequently developed persistent fever. AML was diagnosed via bone marrow biopsy. Chemotherapy was not initiated due to the patient's deteriorating condition, and he ultimately succumbed to presumed intracranial bleeding.
由于凝血功能障碍和血小板减少，急性髓系白血病（AML）的血栓形成并发症并不常见。我们报告了一例独特的AML病例，表现为同时发生肺栓塞和非典型急性心肌梗死。一名67岁男性经历了持续性双侧胸痛。尽管心电图无异常，但D - 二聚体升高和肌钙蛋白T水平轻度升高促使进一步检查，最终诊断为同时发生肺栓塞和急性心肌梗死。患者接受了经皮冠状动脉介入治疗并接受了三联抗栓治疗。然而，在血红蛋白和血小板计数急剧下降后，抗栓治疗中断，患者随后出现持续发热。通过骨髓活检诊断为AML。由于患者病情恶化，未开始化疗，最终因推测的颅内出血死亡。
