Mesane kanserli hastada ciddi akut miyokard enfarktüsü ve periferik toromboz

Öz

Kansere bağlı tromboz, hastaların yaşamlarını önemli ölçüde etkiler. Kansere bağlı trombozun venöz olayları, derin ven trombozu (DVT) ve pulmoner embolinin (PE) yanı sıra visseral veya splanknik ven trombozunu içeren venöz tromboembolizmdir (VTE). Arteriyel olaylar ise inme ve miyokard enfarktüsünü içerir. Bu hastada, miyokard enfarktüsü ve kardiyojenik şok, periferik trombozla birlikte yaygın koroner tromboz ile ilişkilidir.  Hastada kardiyovasküler risk faktörlerinden sigara ve hipertansiyon, ayrıca öyküsünde mesane karsinomu nedeniyle cerrahi mevcuttu. Muhtemelen kanserin kendisi ve cerrahisi tarafından kolaylaştırılan ciddi hiperkoagülan durum çok damar koroner ve periferal yoğun trombüs yüküne neden oldu. Revaskülarizasyon ve trombektomi ameliyatı yapılmadan önce intrakoroner 10 mcg / kg tirofiban bolus ve 15 mg doku plasminojen aktivatörü (tPA) sırasıyla uygulandı. Tam revaskülarizasyon elde edildi.

Anahtar Kelimeler

• mesane kanser,miyokard enfarktüsü,periferik iskemi,tromboz

Severe acute myocardial infarction and peripheral thrombosis in patient with bladder cancer

Abstract

Cancer-associated thrombosis worsens the lives of patients substantially. Venous manifestations of cancer-associated thrombosis include deep vein thrombosis and pulmonary embolism. Arterial events include stroke and myocardial infarction. In this patient, myocardial infarction and cardiogenic shock are associated with diffuse coronary thrombosis together with peripheral thrombosis. He had surgery because of bladder carcinoma. Severe hypercoagulable condition probably facilitated by cancer itself and surgery caused multivessel coronary and peripheral intense thrombus burden. Intracoronary 10 mcg/kg tirofiban bolus and 15 mg tissue plasminogen activator (tPA) were administered respectively before revascularization and thrombectomy operation was performed. Complete revascularization was achieved.

Keywords

• bladder cancer,myocardial infarction,peripheral ischemia

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