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Review
. 2020 Jan 17;20(1):26.
doi: 10.1186/s12872-019-01288-0.

Leriche syndrome in a patient with acute pulmonary embolism and acute myocardial infarction: a case report and review of literature

Xuanqi An  1 , Rui Fu  1 , Zhihui Zhao  1 , Xinhai Ni  1 , Changming Xiong  1 , Xiansheng Cheng  1 , Zhihong Liu  2
Affiliations
Review

Leriche syndrome in a patient with acute pulmonary embolism and acute myocardial infarction: a case report and review of literature

Xuanqi An et al. BMC Cardiovasc Disord. .

Abstract

Background: 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.

Case presentation: 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.

Conclusion: We described the first concurrence of acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.

Keywords: Acute myocardial infarction; Acute pulmonary embolism; Aortoiliac occlusive disease; Leriche syndrome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Computed tomography angiogram of the entire aorta showed multiple newly-formed embolus in pulmonary arteries including main branches (indicated by red arrows)
Fig. 2
Fig. 2
Computed tomography angiogram of the entire aorta showed diffuse calcified occlusions affecting infra-renal abdominal aorta to bilateral common iliac arteries and establishments of collateral vessels (indicated by white arrow heads)
Fig. 3
Fig. 3
Myocardial perfusion Positron Emission Tomography detected decreased viable myocardium in the inferior wall of left ventricle after successful anticoagulation, The datasets analyzed during the current study are not publicly available due to the fact it is a case report
See this image and copyright information in PMC

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