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CC BY-NC-ND 4.0 · Avicenna J Med 2016; 06(04): 120-123
DOI: 10.4103/2231-0770.191450
CASE REPORT

Coronary ectasia in a man on breast cancer therapy presenting with acute coronary syndrome

Dana C Johnson
Department of Cardiology, Lutheran General Hospital, Park Ridge, IL, USA
,
Luay Rifai
Department of Cardiology, Lutheran General Hospital, Park Ridge, IL, USA
,
Parag V Patel
Department of Cardiology, Lutheran General Hospital, Park Ridge, IL, USA
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Limited data exist on the association between breast cancer treatments and coronary artery disease anatomy, particularly in males. We describe an unusual case of diffuse coronary ectasia in a man with breast cancer presenting with acute coronary syndrome (ACS). A 66-year-old man with breast cancer on paclitaxel, tamoxifen, and carboplatin chemotherapy regimen, presents with new onset chest pain. Electrocardiogram reveals anterolateral ST-segment depressions and elevated troponin I level. Emergent angiography revealed grossly ectatic coronary arteries with a total thrombotic occlusion of the mid right coronary artery. Serial intracoronary aspiration thrombectomy revealed fragments of red thrombus. Intracoronary tenectaplase was ultimately administered to restore perfusion. The patient clinically improved and warfarin was added to his cardiac regimen. Laboratory work up for connective tissue disease was negative. Although paclitaxel has been implicated in coronary artery neointima and media proliferation in the setting of drug-eluting stents, we believe our case is the first to describe massive coronary ectasia with significant thrombus burden requiring complex coronary intervention and thrombolysis in the setting of breast cancer therapy in a man.

Keywords

Acute coronary syndrome - breast cancer - coronary ectasia - paclitaxel - percutaneous coronary intervention


Publication History

Article published online:
09 August 2021

© 2016. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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