Du BB, Wang XT, Li XD, Li PP, Chen WW, Li SM, Yang P. Treatment of severe upper gastrointestinal bleeding caused by Mallory-Weiss syndrome after primary coronary intervention for acute inferior wall myocardial infarction: A case report. World J Clin Cases 2019; 7(24): 4407-4413 [PMID: 31911925 DOI: 10.12998/wjcc.v7.i24.4407]
Corresponding Author of This Article
Ping Yang, MD, PhD, Chief Doctor, Director, Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, No. 126, Xiantai Street, Changchun 130031, Jilin Province, China. pyang@jlu.edu.cn
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Cardiac & Cardiovascular Systems
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Case Report
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Dec 26, 2019 (publication date) through Feb 23, 2026
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World Journal of Clinical Cases
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2307-8960
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Du BB, Wang XT, Li XD, Li PP, Chen WW, Li SM, Yang P. Treatment of severe upper gastrointestinal bleeding caused by Mallory-Weiss syndrome after primary coronary intervention for acute inferior wall myocardial infarction: A case report. World J Clin Cases 2019; 7(24): 4407-4413 [PMID: 31911925 DOI: 10.12998/wjcc.v7.i24.4407]
World J Clin Cases. Dec 26, 2019; 7(24): 4407-4413 Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4407
Treatment of severe upper gastrointestinal bleeding caused by Mallory-Weiss syndrome after primary coronary intervention for acute inferior wall myocardial infarction: A case report
Bei-Bei Du, Xing-Tong Wang, Xiang-Dong Li, Pei-Pei Li, Wei-Wei Chen, Si-Ming Li, Ping Yang
Bei-Bei Du, Xiang-Dong Li, Pei-Pei Li, Wei-Wei Chen, Si-Ming Li, Ping Yang, Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
Xing-Tong Wang, Department of Hematology and Oncology, Cancer Center, The First Hospital of Jilin University, Changchun 130031, Jilin Province, China
Author contributions: Du BB and Li PP were the patient’s physicians; Du BB and Chen WW performed the coronary angiography; Li XD and Li SM helped with the endoscopy diagnosis and treatment; Li PP helped with acquisition of data; Du BB, Wang XT, and Li SM reviewed the literature and contributed to manuscript drafting; Du BB, Wang XT, and Yang P were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported byNational Natural Science Foundation of China, No. 81570360; Beijing Lisheng Cardiovascular Grant, No. LHJJ201612425.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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).
Corresponding author: Ping Yang, MD, PhD, Chief Doctor, Director, Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, No. 126, Xiantai Street, Changchun 130031, Jilin Province, China. pyang@jlu.edu.cn
Telephone: +86-431-84995091 Fax: +86-431-84995091
Received: September 14, 2019 Peer-review started: September 14, 2019 First decision: October 24, 2019 Revised: November 3, 2019 Accepted: November 15, 2019 Article in press: November 15, 2019 Published online: December 26, 2019 Processing time: 101 Days and 15.5 Hours
Abstract
BACKGROUND
Upper gastrointestinal bleeding (UGIB) after an acute myocardial infarction (AMI) is not an uncommon complication. Acute UGIB caused by Mallory-Weiss syndrome (MWS) is usually a dire situation with massive bleeding and hemodynamic instability. Acute UGIB caused by MWS after an AMI has not been previously reported.
CASE SUMMARY
A 57-year-old man with acute inferior wall ST elevation myocardial infarction underwent a primary coronary intervention of the acutely occluded right coronary artery. Six hours after the intervention, the patient had a severe UGIB, followed by vomiting. His hemoglobin level dropped from 15.3 g/dL to 9.7 g/dL. In addition to blood transfusion and a gastric acid inhibition treatment, early endoscopy was employed and MWS was diagnosed. Bleeding was stopped by endoscopic placement of titanium clips.
CONCLUSION
Bleeding complications after stent implantation can pose a dilemma. MWS is a rare but severe cause of acute UGIB after an AMI that requires an early endoscopic diagnosis and a hemoclip intervention to stop bleeding.
Core tip: Upper gastrointestinal bleeding (UGIB) after an acute myocardial infarction (AMI) is not an uncommon complication. Acute UGIB caused by Mallory-Weiss syndrome (MWS) after an AMI has not been previously reported. Here we report the diagnosis and management of a 57-year-old AMI patient who developed UGIB caused by MWS shortly after the primary coronary intervention. In addition to blood transfusion and acid inhibition treatment, early endoscopy was employed, and MWS was diagnosed. Bleeding was stopped by endoscopic hemoclip intervention with close monitoring of the hemodynamic status.
