Abstract
A 66-year-old man was admitted to our emergency department for treatment of acute thromboses of multiple abdominal vessels (abdominal aorta, splenic artery and vein, inferior mesenteric artery, and portal vein). Chest computed tomography (CT) performed 2 days before admission showed no abnormality in the left ventricular myocardium (Figure 1). Laboratory findings suggested a hematologic disorder, and therapeutic anticoagulation with heparin was initiated. A bone marrow biopsy was conducted that revealed chronic myelomonocytic leukemia as the underlying disease. Three days after admission, the patient reported severe chest pain. Blood testing revealed elevated levels of high-sensitivity troponin T (155 ng/L [normal <14 ng/L]), normal levels of creatine kinase (30 U/L [normal<190 U/L]), activated partial thromboplastin time of 78 seconds (therapeutic activated partial thromboplastin time range, 45–75 seconds), and a slightly increased international normalized ratio of 1.3 (normal <1.2). ECG showed sinus tachycardia but no changes indicating …
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