Spontaneous Retro-Orbital Subperiosteal Hemorrhage with Complete Resolution Following Percutaneous Coronary Intervention for Acute Myocardial Infarction.
Among the several treatment strategies available for acute myocardial infarction, primary percutaneous coronary intervention concomitant with antithrombotic agents is the primary treatment used to facilitate coronary reperfusion. However, bleeding can create major complications. Here we have presented a case of acute myocardial infarction treated with reperfusion therapy, after which developed a sudden onset of proptosis, with high intraocular pressure, blurred vision, and ecchymosis of the left eye. Spontaneous retro-orbital subperiosteal hemorrhage, a rare complication, was diagnosed based on those symptoms as noted above, as well as other orbital signs and imaging evaluation. Multiple antithrombotic agents, including antiplatelets, low molecular weight heparin, and glycoprotein IIb/IIIa receptor inhibitor were thought to be the main precipitating factors of this complication. Thereafter, conservative medical treatment was applied. In the following 2 weeks, all the patient's orbital signs resolved gradually without visual impairment. In conclusion, our experience with a rare case of complications arising from reperfusion therapy used to treat myocardial infarction suggests that clinicians should remain vigilant for any hemorrhagic events during acute myocardial infarction treatment.


BACKGROUND
Acute myocardial infarction; Percutaneous coronary intervention; Retro-orbital subperiosteal hemorrhage.
Divison of Cardiology, Department of Medicine, Mackay Memorial Hospital;
Hsu-Ping
HP
Wu
Tuan Jung Eye Clinic, Taichung, Taiwan.
Chia-Jung
CJ
Tsai
Divison of Cardiology, Department of Medicine, Mackay Memorial Hospital; ; Department of Medicine, Mackay Medical College, and Mackay Medicine, Nursing and Management College;
Jui-Peng
JP
Tsai
Divison of Cardiology, Department of Medicine, Mackay Memorial Hospital;
Chung-Lieh
CL
Hung
Divison of Cardiology, Department of Medicine, Mackay Memorial Hospital; ; Divison of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, Taipei;
Jen-Yuan
JY
Kuo
Divison of Cardiology, Department of Medicine, Mackay Memorial Hospital;
Charles Jia-Yin
CJ
Hou