Scafa-Udriste A, Popa-Fotea NM, Bataila V, Calmac L, Dorobantu M. Acute inferior myocardial infarction in a young man with testicular seminoma: A case report. World J Clin Cases 2021; 9(16): 4040-4045 [PMID: 34141764 DOI: 10.12998/wjcc.v9.i16.4040]
Corresponding Author of This Article
Nicoleta-Monica Popa-Fotea, MD, Assistant Professor, Department of Cardio-Thoracic, University of Medicine and Pharmacy, No. 8 Eroii Sanitari, Bucharest 050474, Romania. nicoleta.popa-fotea@drd.umfcd.ro
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2021; 9(16): 4040-4045 Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.4040
Acute inferior myocardial infarction in a young man with testicular seminoma: A case report
Alexandru Scafa-Udriste, Nicoleta-Monica Popa-Fotea, Vlad Bataila, Lucian Calmac, Maria Dorobantu
Alexandru Scafa-Udriste, Nicoleta-Monica Popa-Fotea, Maria Dorobantu, Department of Cardio-Thoracic, University of Medicine and Pharmacy, Bucharest 050474, Romania
Alexandru Scafa-Udriste, Nicoleta-Monica Popa-Fotea, Vlad Bataila, Lucian Calmac, Maria Dorobantu, Department of Cardiology, Emergency Clinical Hospital, Bucharest 014461, Romania
Author contributions: Scafa-Udriste A, Popa-Fotea NM, Bataila V and Calmac L collected and analyzed the data; Popa-Fotea NM drafted the article; Scafa-Udriste A and Popa-Fotea NM conceived of and designed the study, acquired the funding, and revised the manuscript for important intellectual content; all authors read and approved the final version of the manuscript.
Supported byExecutive Agency for Higher Education, Research, Development and Innovation Funding, No. PN-III-P2-2.1-PED- 2019-2434.
Informed consent statement: Written informed consent was obtained from each individual presented herein, for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this study or its publication.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nicoleta-Monica Popa-Fotea, MD, Assistant Professor, Department of Cardio-Thoracic, University of Medicine and Pharmacy, No. 8 Eroii Sanitari, Bucharest 050474, Romania. nicoleta.popa-fotea@drd.umfcd.ro
Received: January 15, 2021 Peer-review started: January 15, 2021 First decision: January 24, 2021 Revised: January 29, 2021 Accepted: March 23, 2021 Article in press: March 23, 2021 Published online: June 6, 2021 Processing time: 118 Days and 12.6 Hours
Abstract
BACKGROUND
Atherosclerosis represents the main cause of myocardial infarction (MI); other causes such as coronary embolism, vasospasm, coronary-dissection or drug use are much rarely encountered, but should be considered in less common clinical scenarios. In young individuals without cardiovascular risk factors, the identification of the cause of MI can sometimes be found in the medical history and previous treatments undertaken.
CASE SUMMARY
We present the case of a 34-year-old man presenting acute inferior ST-elevation MI without classic cardiac risk factors. Seven years ago, he suffered from orchidopexy for bilateral cryptorchidism, and was recently diagnosed with right testicular seminoma for which he had to undergo surgical resection and chemotherapy with bleomycin, etoposide and cisplatin. Shortly after the first chemotherapy treatment, namely on day five, he suffered an acute MI. Angiography revealed a mild stenotic lesion at the level of the right coronary artery with suprajacent thrombus and vasospasm, with no other significant lesions on the other coronary arteries. A conservative treatment was decided upon by the cardiac team, including dual antiplatelets therapy and anticoagulants with good further evolution. The patient continued the chemotherapy treatment according to the initial plan without other cardiovascular events.
CONCLUSION
In young individuals with no cardiovascular risk factors undergoing aggressive chemotherapy, an acute MI can be caused by vascular toxicity of several anti-cancer drugs.
Core Tip: Atherosclerosis represents the main cause of acute myocardial infarction (MI), but less frequent causes should be evaluated in young individuals not at risk of such cardiac events. Aggressive chemotherapy for testicular seminoma increases vascular toxicity that may induce acute MI, complicating the clinical course of the subject. Under conservative treatment with antiplatelets and anticoagulants, the clinical evolution of subjects is favorable, but with the extant risk of repeating cardiac events on further chemotherapy courses.
