Severe Bleeding after Antithrombotic Therapy in Urosepsis Masquerading as Myocardial Infarction

DOI Web Site 参考文献10件
  • Cheng Kuo-Wei
    Emergency Department, Taipei Veterans General Hospital, Taiwan Department of Emergency Medicine, National Yang-Ming University School of Medicine, Taiwan
  • Shih Hsin-Chin
    Emergency Department, Taipei Veterans General Hospital, Taiwan Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taiwan
  • How Chorng-Kuang
    Emergency Department, Taipei Veterans General Hospital, Taiwan Department of Emergency Medicine, National Yang-Ming University School of Medicine, Taiwan
  • Lin Yang-Ying
    Emergency Department, Taipei Veterans General Hospital, Taiwan Department of Emergency Medicine, National Yang-Ming University School of Medicine, Taiwan
  • Hung-Tsang Yen David
    Emergency Department, Taipei Veterans General Hospital, Taiwan Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taiwan
  • Huang Mu-Shun
    Emergency Department, Taipei Veterans General Hospital, Taiwan Department of Emergency Medicine, National Yang-Ming University School of Medicine, Taiwan

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抄録

Cardiac dysfunction is common in patients with severe sepsis and septic shock. We present a 71-year-old woman with Escherichia coli urosepsis and sepsis-induced myocardial injury masquerading as non-ST elevated myocardial ischemia. Spontaneous psoas hematoma requiring blood transfusion and intracranial hemorrhage developed after antiplatelet and anticoagulant therapies, even in therapeutic doses. The patient was managed conservatively and recovered well with minor residual hemiparesis. Bleeding complications are a common risk of antithrombotic therapy. It is therefore crucial to weigh the impact of efficacy against safety. Old age, female gender, renal insufficiency and sepsis character increased the risk of bleeding in this patient. A misinterpretation of elevated cardiac troponin I may give rise to a diagnostic dilemma and cause unnecessary morbidity.<br>

収録刊行物

  • Internal Medicine

    Internal Medicine 50 (7), 779-782, 2011

    一般社団法人 日本内科学会

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