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胰腺癌合并心肌梗死和肺栓塞:1例特鲁索综合征两种表现的病例报告

Myocardial infarction and pulmonary embolism in pancreatic cancer: a case report of two manifestations of Trousseau's syndrome.

作者信息

Oh Seok, Kim Ju Han, Sim Doo Sun, Hong Young Joon, Ahn Youngkeun, Jeong Myung Ho

机构信息

Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea.

Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.

出版信息

Front Cardiovasc Med. 2025 Mar 31;12:1558848. doi: 10.3389/fcvm.2025.1558848. eCollection 2025.

Abstract

INTRODUCTION

The simultaneous occurrence of acute myocardial infarction (AMI) and venous thromboembolism (VTE) is rare and often associated with underlying malignancies. This study reports a rare case of concurrent AMI and pulmonary thromboembolism in a patient diagnosed with pancreatic cancer.

CASE PRESENTATION

A 70-year-old woman presented with acute chest pain and ST-segment elevation myocardial infarction, prompting immediate percutaneous coronary intervention (PCI) with the deployment of a drug-eluting stent. Following PCI, she was treated with optimal medical therapy, including dual antiplatelet therapy. Subsequent investigations revealed pulmonary embolism, deep vein thrombosis, and imaging findings suggestive of pancreatic cancer. Anticoagulation therapy was initiated to manage the VTE. Approximately 1 month after PCI, antithrombotic agents were temporarily discontinued for pancreatic mass biopsy, confirming pancreatic ductal adenocarcinoma. The patient was referred for palliative chemotherapy.

DISCUSSION

This case highlights the clinical manifestation of Trousseau's syndrome, characterized by cancer-associated thromboembolism, and underscores the importance of coordinated antithrombotic management in complex clinical settings.

摘要

引言

急性心肌梗死(AMI)与静脉血栓栓塞症(VTE)同时发生的情况较为罕见,且常与潜在的恶性肿瘤相关。本研究报告了一例诊断为胰腺癌的患者并发AMI和肺血栓栓塞症的罕见病例。

病例介绍

一名70岁女性因急性胸痛和ST段抬高型心肌梗死就诊,随即接受了药物洗脱支架植入的直接经皮冠状动脉介入治疗(PCI)。PCI术后,她接受了包括双联抗血小板治疗在内的最佳药物治疗。随后的检查发现了肺栓塞、深静脉血栓形成,且影像学检查结果提示患有胰腺癌。开始抗凝治疗以处理VTE。PCI术后约1个月,为进行胰腺肿块活检暂时停用了抗血栓药物,确诊为胰腺导管腺癌。该患者被转诊接受姑息化疗。

讨论

本病例突出了以癌症相关血栓栓塞为特征的特鲁索综合征的临床表现,并强调了在复杂临床情况下进行抗血栓治疗协调管理的重要性。

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