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初诊为不明原因静脉血栓栓塞后发生急性心肌梗死:一例报告

Acute myocardial infarction after initially diagnosed with unprovoked venous thromboembolism: A case report.

作者信息

Seo Jeongduk, Lee Joonpyo, Shin Yong Hoon, Jang Albert Youngwoo, Suh Soon Yong

机构信息

Department of Cardiology, Gachon University Gil Medical Center, Incheon 405-760, South Korea.

出版信息

World J Clin Cases. 2023 Oct 26;11(30):7497-7501. doi: 10.12998/wjcc.v11.i30.7497.

Abstract

BACKGROUND

Protein C deficiency is typically associated with venous thromboembolism; however, arterial thrombosis has been reported in several cases. We report the case of a patient with pulmonary thromboembolism and deep vein thrombosis following acute myocardial infarction with high thrombus burden.

CASE SUMMARY

A 40-year-old man was diagnosed with pulmonary thromboembolism and deep vein thrombosis without any provoking factors. The patient was treated with anticoagulants for six months, which were then discontinued. Three months after the discontinuation of anticoagulant therapy, the patient was hospitalized with chest pain and diagnosed with acute myocardial infarction with high thrombus burden. Additional tests revealed protein C deficiency associated with thrombophilia. The patient was treated with anticoagulants combined with dual antiplatelet agents for 1 year after percutaneous coronary intervention, and no recurrent events were reported during a follow-up period of 5 years.

CONCLUSION

Recurrent thromboembolic events including acute myocardial infarction with thrombus should be considered an alarming sign of thrombophilia.

摘要

背景

蛋白C缺乏通常与静脉血栓栓塞相关;然而,已有数例动脉血栓形成的报道。我们报告一例急性心肌梗死后伴有高血栓负荷的肺血栓栓塞和深静脉血栓形成患者的病例。

病例摘要

一名40岁男性被诊断为无任何诱发因素的肺血栓栓塞和深静脉血栓形成。该患者接受了6个月的抗凝治疗,随后停药。抗凝治疗停药3个月后,患者因胸痛住院,被诊断为伴有高血栓负荷的急性心肌梗死。进一步检查发现与易栓症相关的蛋白C缺乏。经皮冠状动脉介入治疗后,该患者接受了1年的抗凝治疗联合双联抗血小板药物治疗,在5年的随访期内未报告复发性事件。

结论

包括伴有血栓的急性心肌梗死在内的复发性血栓栓塞事件应被视为易栓症的警示信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2905/10643057/476ef9e30c5f/WJCC-11-7497-g001.jpg

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