Acute myocardial infarction in a patient with essential thrombocythemia: successful treatment with percutaneous transluminal coronary recanalization.
A 65-year-old woman with essential thrombocythemia (ET) was admitted to hospital where she was diagnosed as acute myocardial infarction (AMI). Because of abundant thrombus of right coronary arteries, percutaneous transluminal coronary recanalization by administration of urokinase was selected as the reperfusion therapy, resulting in successful revascularization with Thrombolysis in Myocardial Infarction grade III coronary flow. The maximum creatine kinase reached 507 IU/L, and left ventriculography performed at 1 month after initiation of both anticoagulant and antiplatelet therapies revealed reduced motion in the inferior wall with an ejection fraction of 57%. Despite good recovery of left ventricular function, bleeding complications, such as epistaxis or ecchymoma, which did not require blood transfusion, occurred during the clinical course. Because ET causes not only thrombus formation but also bleeding tendency, it is very important to carefully follow-up any clotting abnormality in AMI patients with ET.
Mizuta
Einosuke
E
Department of Regenerative Medicine and Regenerative Therapeutics, Institute of Regenerative Medicine and Biofunction, Tottori Graduate School of Medical Science, Tottori University, Tottori, Japan. einosuke@grape.med.tottori-u.ac.jp
Takeda
Shin-ichi
S
Sasaki
Norihito
N
Miake
Junichiro
J
Hamada
Toshiriro
T
Shimoyama
Masaki
M
Tajima
Fumihito
F
Igawa
Osamu
O
Shigemasa
Chiaki
C
Hisatome
Ichiro
I
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010960:Plasminogen Activators / Q000008:administration & dosage*; D013920:Thrombocythemia, Essential / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator