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Volume 8, Issue 9 (Suppl) J Clin Exp Cardiolog, an open access journal
ISSN: 2155-9880 Euro Cardiology 2017
October 16-18, 2017
October 16-18, 2017 | Budapest, Hungary
20th European Cardiology Conference
Johan Aris Chandran et al., J Clin Exp Cardiolog 2017, 8:9(Suppl)
DOI: 10.4172/2155-9880-C1-078
An unusual case of acute stent thrombosis: A review of a rare cause of acute stent occlusion
Johan Aris Chandran (East of England NHS UK) and Ben Coumbe (UCL medical student)
Princess Alexandra Hospital, UK
We present a case of a 55-year-old woman diagnosed with an ST-elevation myocardial infarction, on the background
of receiving chemotherapy for metastatic ovarian cancer. She underwent primary angioplasty followed by a repeat
angioplasty two hours later due to acute stent thrombosis. She also developed an acute ischaemic right index finger consistent
with a likely embolic event. She was subsequently diagnosed to have acute severe thrombocytosis. Acute stent thrombosis is
a rare complication with an incidence of between 0.1 – 0.5%. The common causes of acute stent thrombosis are suboptimal
stent deployment, under-sizing of the stent or accidental discontinuation of anti-platelet treatment. In this case, our patient
had no identifiable cardiovascular risk factors, and it may be possible that the initial event may also have been due to severe
thrombocytosis. The systemic anti-cancer treatment she was receiving at the time was not known to be associated with
increased cardiovascular risk. The recurrent stent thrombosis that occurred in this setting was, however, likely due to the
significant reactive thrombocytosis. The underlying cause of the thrombocytosis is critical in determining the appropriate
management of the condition. In this case, the aetiology is a subject for debate and may not be solely attributable to being
secondary to the cardiac event. The observed thrombocytosis could potentially be explained by the side effect of gemcitabine-
induced thrombocytosis or an inflammatory reaction from the primary cancer. This case highlights the role of exploring a
broad differential diagnosis in cases of recurrent acute stent thrombosis, and is a very rare case of reactive thrombocytosis in
a patient on systemic anti-cancer treatment presenting as a myocardial infarction. It highlights the benefits of inter-specialty
liaison for delivering better patient care especially in complicated treatment regimes for a number of disorders in various
medical specialties.
Biography
Johan Aris Chandran (MA, MB BChir) is currently a core medical trainee at the Princess Alexandra Hospital, UK and intends to pursue cardiology as a future career.