JACC. Case reports · 2026
Non-ST-Segment Elevation Myocardial Infarction as the Initial Presentation of Chronic Lymphocytic Leukemia.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Gitte Pramod Tulsidas, Kharche Milind, Khedkar Umesh
Аннотация
BACKGROUND: Acute coronary syndrome is an uncommon initial manifestation of chronic lymphocytic leukemia (CLL).
CASE SUMMARY: A 55-year-old man presenting with non-ST-segment elevation myocardial infarction. Coronary angiography revealed thrombotic total mid-left anterior descending artery occlusion, and intravascular ultrasound confirmed a fibro-fatty plaque, successfully treated with percutaneous coronary intervention. Laboratory testing revealed marked lymphocytosis, and flow cytometry confirmed Rai stage I CLL, managed conservatively under hematologic supervision.
DISCUSSION: Myocardial infarction as the first manifestation of CLL is exceedingly rare and may occur due to leukostasis, coronary infiltration, or a paraneoplastic prothrombotic mechanism. The multimodality imaging assists in identifying mechanisms.
TAKE-HOME MESSAGES: Persistent lymphocytosis during acute coronary syndrome warrants hematologic evaluation. CLL may rarely present with myocardial infarction. Recognition of this presentation is crucial for timely multidisciplinary management.
CASE SUMMARY: A 55-year-old man presenting with non-ST-segment elevation myocardial infarction. Coronary angiography revealed thrombotic total mid-left anterior descending artery occlusion, and intravascular ultrasound confirmed a fibro-fatty plaque, successfully treated with percutaneous coronary intervention. Laboratory testing revealed marked lymphocytosis, and flow cytometry confirmed Rai stage I CLL, managed conservatively under hematologic supervision.
DISCUSSION: Myocardial infarction as the first manifestation of CLL is exceedingly rare and may occur due to leukostasis, coronary infiltration, or a paraneoplastic prothrombotic mechanism. The multimodality imaging assists in identifying mechanisms.
TAKE-HOME MESSAGES: Persistent lymphocytosis during acute coronary syndrome warrants hematologic evaluation. CLL may rarely present with myocardial infarction. Recognition of this presentation is crucial for timely multidisciplinary management.