Acute myocardial infarction and sub-acute stent thrombosis associated with occult essential thrombocythemia  

作　　者：Zafer Isilak Mehmet Tezcan Murat Atalay Ejder Kardesoglu 

机构地区：[1]Department of Cardiology, Gulhane Military Medical Academy,Haydarpasa Training Hospital, Istanbul, Turkey [2]Department of Cardiology, Gumussuyu Military Hospital, Istanbul,Turkey [3]Department of Cardiology, Merzifon Military Hospital, Amasya,Turkey

出　　处：《Chinese Medical Journal》2014年第19期3512-3513,共2页中华医学杂志（英文版）

摘　　要：70-year-old female with no Aprevious cardiac history resented with complaints of severe chest and back pain lasting for 20 minutes. She had a past history of type 2 diabetes mellitus for five years and hypertension for twenty years, but denied a history of hyperlipidemia, smoking or hemorrhagic disorder. There was no family history of coronary artery or hematologic disease. On physical examination, the blood pressure was 145/90 mmHg and the heart rate was 102 beats/rain. Cardiac examination revealed normal S1 and $2 sounds. There were no murmors or clicks. The lungs were clear on auscultation. Hepatosplenomegaly or lymphadenopathy was not detected. Her electrocardiogram showed ST elevations in lead V1-V6, consistent with acute anterior MI and echocardiogram supported the diagnosis with a slight reduction in wall motion in the anterior region. Complete blood count revealed a white blood cell count of 9 000/mm3 with a normal differential, red blood cell count of 3.5×106/mm3, hematocrit of 40.2%, and platelet count of 238 000/mm3. Emergent coronary angiography demonstrated proximal thrombotic occlusion of the left anterior descending artery （LAD） （Figure 1A）. A loading dose of 600 mg clopidogrel and 300 mg acetylsalicylic asid （ASA） was given immediately. After administration of 10 000 U intravenous heparin, angioplasty was performed and a 3.0 mm×20.0 mm bare metal stent （BMS） was deployed to the LAD. Repeat angiogram revealed TIMI III flow in the LAD （Figure 1B）. Five days later, the patient was discharged without any bleeding or thrombotic complications. She was receiving dual antiplatelet therapy with ASA and clopidogrel 150 mg daily. However, she was admitted to our hospital again with severe chest pain just one day after dischargement. Her platelet count of 487 000/mm3 was remarkable in comparison with her previous complete blood count. Electrocardiogram showed ST elevations in leads V1-V6, suggestive of an acute anterior reinfarction. Coronary angiography revealed in- stent thrombosis in 70-year-old female with no Aprevious cardiac history resented with complaints of severe chest and back pain lasting for 20 minutes. She had a past history of type 2 diabetes mellitus for five years and hypertension for twenty years, but denied a history of hyperlipidemia, smoking or hemorrhagic disorder. There was no family history of coronary artery or hematologic disease. On physical examination, the blood pressure was 145/90 mmHg and the heart rate was 102 beats/rain. Cardiac examination revealed normal S1 and $2 sounds. There were no murmors or clicks. The lungs were clear on auscultation. Hepatosplenomegaly or lymphadenopathy was not detected. Her electrocardiogram showed ST elevations in lead V1-V6, consistent with acute anterior MI and echocardiogram supported the diagnosis with a slight reduction in wall motion in the anterior region. Complete blood count revealed a white blood cell count of 9 000/mm3 with a normal differential, red blood cell count of 3.5×106/mm3, hematocrit of 40.2%, and platelet count of 238 000/mm3. Emergent coronary angiography demonstrated proximal thrombotic occlusion of the left anterior descending artery （LAD） （Figure 1A）. A loading dose of 600 mg clopidogrel and 300 mg acetylsalicylic asid （ASA） was given immediately. After administration of 10 000 U intravenous heparin, angioplasty was performed and a 3.0 mm×20.0 mm bare metal stent （BMS） was deployed to the LAD. Repeat angiogram revealed TIMI III flow in the LAD （Figure 1B）. Five days later, the patient was discharged without any bleeding or thrombotic complications. She was receiving dual antiplatelet therapy with ASA and clopidogrel 150 mg daily. However, she was admitted to our hospital again with severe chest pain just one day after dischargement. Her platelet count of 487 000/mm3 was remarkable in comparison with her previous complete blood count. Electrocardiogram showed ST elevations in leads V1-V6, suggestive of an acute anterior reinfarction. Coronary angiography revealed in- stent thrombosis in

关 键 词：acute myocardial infarction essential thromboeythemia sub-acute stent thrombosis 

分 类 号：R542.22[医药卫生—心血管疾病]