Acute Myocardial Infarction Due to Chronic Myelogenous Leukemia

¹ Cardiovascular Unit, Department of Medicine, Peter Bent Brigham Hospital and Harvard Medical School
² Junior Assistant Resident, Department of Pathology, Peter Bent Brigham Hospital and Harvard Medical School

Myocardial infiltration by leukemic granulocytes in association with a myeloproliferative malignancy is common. For reasons not clearly understood, clinical manifestations are unusual and myocardial infarction is rare. A patient is described in whom acute myocardial infarction is associated with myocardial granulocytic and myeloblastic infiltration and normal coronary arteries. The diagnosis of infarction in this clinical setting was supported by appropriate ECG and enzyme changes, as well as histologic examination of the myocardium and pathologic study of the coronary arteries. The findings in this patient may have been caused by extensive ventricular leukemic infiltration and small vessel distortion resulting in necrosis. With the advent of new therapeutic regimens, a diagnosis of this condition may be made with increasing frequency.