Double Trouble: A Rare Association between Chronic Total Occlusion of the Left Main Coronary Artery and Colonic Malignancy

Author:

Sarojadevi Ashida Thulaseedharan1,Arasappa Arunkumar2,Eugin Priscilla Rubavathy3,Ramaraj Krishna Prabu4,Fernando Anto Mariadoss5

Affiliation:

1. Department of Cardiology, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

2. Cardiothoracic and Vascular Surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

3. Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

4. Department of Anaesthesiology, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

5. Department of General Surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

Abstract

AbstractEmerging evidence has shown an association between cardiovascular (CV) disease and cancer due to shared risk factors and biological mechanisms especially chronic inflammation. The objective of this case report is to highlight the association between these two lethal diseases and the challenges in the management of coronary artery disease in patients with coexisting malignancy.A 65-year-old nonsmoker, nondiabetic, and normotensive male presented with a history of abdominal pain and significant weight loss. Colonoscopy and biopsy showed adenocarcinoma of the ascending colon, and he was planned for right hemicolectomy. Electrocardiogram exercise stress test performed as a part of preoperative evaluation was strongly positive. Coronary angiography was suggestive of Chronic total occlusion of the left main coronary artery. Though the syntax score was intermediate, coronary artery bypass grafting was decided as the revascularization strategy as he needed early surgery for the colonic malignancy. A month later, he underwent right hemicolectomy.Clinicians should be aware of the association between CV disease and cancer as they are likely to face similar situations where both coexist. Understanding the connections between heart disease and cancer will help to formulate combined preventive guidelines.

Publisher

Georg Thieme Verlag KG

Subject

Ocean Engineering

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