Essential thrombocythemia with non-ST-segment elevation myocardial infarction as the first manifestation:A case report  

作　　者：Zhi-Ming Wang Wei-Hai Chen Yan-Ming Wu Lin-Quan Wang Fu-Long Ye Ren-Lin Yin 

机构地区：[1]Department of Cardiology,Suzhou Ninth People's Hospital,Soochow University,Suzhou 215200,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2022年第21期7422-7428,共7页世界临床病例杂志

摘　　要：BACKGROUND We report a case of essential thrombocythemia(ET)in a 44-year-old male who exhibited non-ST-segment-elevation myocardial infarction(NSTEMI)as the first manifestation without known cardiovascular risk factors(CVRFs).For the first time,we reported a left main trifurcation lesion in NSTEMI caused by ET,including continuous stenosis lesions from the left main to the ostial left anterior descending(LAD)artery and an obvious thrombotic lesion in the ostial and proximal left circumflex(LCX)artery.There was 60%diffuse stenosis in the left main(LM)that extended to the ostial LAD,thrombosis of the ostial LAD and proximal LCX,and 90%stenosis in the proximal LCX.During the operation,thrombus aspiration was performed,but no obvious thrombus was aspirated.Performing the kissing balloon technique(KBT)in the LCX and LM unexpectedly increased the narrowness of the LAD.Then,the single-stent crossover technique,final kissing balloon technique and proximal optimization technique(POT)were performed.On the second day after percutaneous coronary intervention(PCI),the number of platelets(PLTs)still increased significantly to as high as 696×10^(9)/L.The bone marrow biopsy done later,together with JAK2(exon 14)V617F mutation,confirms the diagnosis of ET.Hydroxyurea was administered to inhibit bone marrow proliferation to control the number of PLTs.CASE SUMMARY A 44-year-old male patient went to a local hospital for treatment for intermittent chest pain occurring over 8 h.The examination at the local hospital revealed elevated cTnI and significantly elevated platelet.Then,he was diagnosed with acute myocardial infarction and transferred to our hospital for emergency interventional treatment by ambulance.During the operation,thrombus aspiration,the single-stent crossover technique,final kissing balloon technique and POT were performed.Dual antiplatelet therapy comprising aspirin and ticagrelor was used after PCI.Evidence of mutated JAK2 V617F and bone marrow biopsy shown the onset of ET.Together with JAK2(exon 14)V617F mutation,

关 键 词：Essential thrombocythemia Non-ST-segment-elevation myocardial infarction Percutaneous coronary intervention HYDROXYUREA Case report 

分 类 号：R542.22[医药卫生—心血管疾病] R558.3[医药卫生—内科学]