Kazuyoshi Kousaka, Nobuhiro Takeuchi, Masanori Takada, Koichi Fujita, Yoshiharu Nishibori and Takao Maruyama
An 80-year-old male was admitted to our institution with a complaint of chest pain. Electrocardiography revealed ST elevation in leads V1-V5, blood chemistry revealed elevated creatine kinase MB and troponin T levels, and transthoracic echocardiography revealed akinesis in the anterior wall of the left ventricle. Although chest radiography revealed no cardiac or respiratory abnormalities, multiple small nodules in both lungs were identified. A diagnosis of Acute Myocardial Infarction (AMI) was made and Cardioangiography (CAG) was performed, which revealed a severely stenotic lesion in the proximal left descending artery. After thrombectomy, drug-eluting stents were successfully placed. However, intramuscular hemorrhage in the right upper arm and hematuria occurred; moreover, the platelet count decreased to 7.5×104/μL, leading to a suspicion of Disseminated Intravascular Coagulation (DIC). Following treatment of the DIC, the chest nodules detected earlier were investigated further by whole-body computed tomography and magnetic resonance imaging, which revealed a tumor in the prostate gland with metastases to the first lumbar vertebra, ischial bone, and hyoid bone. Prostate cancer was thus detected during examination and diagnosis of AMI and DIC, suggesting an association between the underlying cancer and coagulation disorders such as DIC, venous thromboembolism, and acute coronary syndrome, similar to our patient. This case report suggests that physicians should be mindful of underlying disorders when encountering thrombotic diseases.
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