Abstract
Abstract
Background
Both acute myocardial infarction and acute pulmonary embolism are distinct medical urgencies while they may conincide. Leriche’s syndrome is a relatively rare aortoiliac occlusive disease characterized by claudication, decreased femoral pulses, and impotence. We present the first case of concomitant acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.
Case presentation
A 56-year-old male with a history of intermittent claudication was admitted for evaluating the sudden onset of chest pain. Elevated serum troponin level, sustained high D-dimer level, ST-T wave changes on electrocardiogram, and segmental wall motion abnormality of the left ventricle on transthoracic echocardiography were noted. Pulmonary Computed Tomography Angiogram revealed multiple acute emboli. Aortic Computed Tomography Angiogram spotted complete obstructions of the subrenal aorta and bilateral common iliac arteries with collateral circulation, maintaining the vascularization of internal and external iliac arteries. We stated the diagnosis of acute pulmonary embolism and Leriche syndrome and initiated oral anticoagulation. However, Q waves on electrocardiogram and wall motion abnormality on echocardiography persisted after embolus dissolved successfully. Coronary computed tomography angiogram found coronary arterial plaques while myocardial Positron Emission Tomography detected decreased viable myocardium of the left ventricle. We subsequently ratified the diagnosis of concurrent acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome. The patient was discharged and has been followed up at our center.
Conclusion
We described the first concurrence of acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.
Funder
National Precision Medical Research Program of China
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference27 articles.
1. Akgedik R, Günaydin ZY, Botan Yildirim B, Eren Dagli C, Bektas O. What should be done in the event of simultaneous massive pulmonary embolism and myocardial infarction with ST elevation? Turk Kardiyol Dern Ars. 2015;43(8):734–8.
2. Kosuge M, Kimura K, Ishikawa T, Ebina T, Hibi K, Nakachi T, et al. Electrocardiographic differentiation between acute pulmonary embolism and acute coronary syndromes on the basis of negative T waves. Am J Card. 2007;99(6):817–21.
3. Ramineni R, Daniel GK. Association of a Patent Foramen Ovale with Myocardial Infarction and Pulmonary Emboli in a Peripartum woman. Am J Med Sci. 2010;340:4.
4. Bajaj N, Bozarth AL, Guillot J, Kojokittah J, Appalaneni SR, Cestero C, et al. Clinical features in patients with pulmonary embolism at a community hospital: analysis of 4 years of data. J Thromb Thrombolysis. 2014;37:287–92.
5. McCoy CE, Patierno S, Lotfipour F. Leriche syndrome presenting with multisystem Vaso-occlusive catastrophe. West J Emerg Med. 2015;16(4):583–6.
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