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Abstract：
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.
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.
We described the first concurrence of acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.
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.
We described the first concurrence of acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.
摘要：
急性心肌梗塞和急性肺栓塞都是不同的医疗紧急情况，但它们可能同时发生。Leriche综合征是一种相对罕见的以跛行为特征的主髂动脉闭塞性疾病，股骨脉搏减少，和阳痿。我们介绍了第一例并发急性肺栓塞，急性心肌梗死,和Leriche综合征.
一名有间歇性跛行病史的56岁男性因评估突发胸痛而入院。血清肌钙蛋白水平升高,持续的高D-二聚体水平，心电图ST-T波改变,经胸超声心动图检查发现左心室节段性运动异常。肺计算机断层扫描血管造影显示多发急性栓塞。主动脉计算机断层扫描血管造影发现肾下主动脉和双侧髂总动脉完全阻塞并伴有侧支循环，维持髂内动脉和髂外动脉的血管形成。我们陈述了急性肺栓塞和Leriche综合征的诊断，并开始口服抗凝治疗。然而,栓子成功溶解后，心电图上的Q波和超声心动图上的壁运动异常持续存在。冠状动脉计算机断层扫描血管造影发现冠状动脉斑块，而心肌正电子发射断层扫描发现左心室存活心肌减少。我们随后批准了并发急性肺栓塞的诊断，急性心肌梗死,和Leriche综合征.患者已出院，并已在我们中心进行了随访。
我们描述了急性肺栓塞的首次并发，急性心肌梗死,和Leriche综合征.
一名有间歇性跛行病史的56岁男性因评估突发胸痛而入院。血清肌钙蛋白水平升高,持续的高D-二聚体水平，心电图ST-T波改变,经胸超声心动图检查发现左心室节段性运动异常。肺计算机断层扫描血管造影显示多发急性栓塞。主动脉计算机断层扫描血管造影发现肾下主动脉和双侧髂总动脉完全阻塞并伴有侧支循环，维持髂内动脉和髂外动脉的血管形成。我们陈述了急性肺栓塞和Leriche综合征的诊断，并开始口服抗凝治疗。然而,栓子成功溶解后，心电图上的Q波和超声心动图上的壁运动异常持续存在。冠状动脉计算机断层扫描血管造影发现冠状动脉斑块，而心肌正电子发射断层扫描发现左心室存活心肌减少。我们随后批准了并发急性肺栓塞的诊断，急性心肌梗死,和Leriche综合征.患者已出院，并已在我们中心进行了随访。
我们描述了急性肺栓塞的首次并发，急性心肌梗死,和Leriche综合征.
