Disseminated intravascular coagulation in metastatic prostate cancer can rarely present with simultaneous acute ischemic stroke and myocardial infarction alongside severe bleeding.
This case highlights the rare presentation of simultaneous ischemic stroke and myocardial infarction due to malignancy-associated DIC, emphasizing the need for early recognition and balanced management of concurrent thrombosis and bleeding.
Absolute Event Rate: 0% vs 0%
Abstract Disseminated intravascular coagulation (DIC) is a severe consumptive coagulopathy seen in malignancy, characterized by simultaneous thrombosis and bleeding. Concurrent arterial thromboses, such as acute ischemic stroke and myocardial infarction, are rare manifestations. We present a 59-year-old male with metastatic prostatic carcinoma who presented with right-sided hemiparesis and slurred speech. MRI revealed a left middle cerebral artery infarct with subdural hematoma. Laboratory evaluation showed anemia, thrombocytopenia, and coagulopathy. ECG and elevated cardiac biomarkers confirmed an anterior wall myocardial infarction with pulmonary edema. Ongoing bleeding and worsening cytopenias prompted evaluation for DIC, which was confirmed by low fibrinogen and elevated fibrin degradation products. The patient was managed with ventilatory support, cautious antiplatelet therapy, blood component replacement, fibrinogen concentrate, prothrombin complex, vasopressors, and diuretics. Coagulation parameters improved, bleeding subsided, and he was successfully extubated. This case underscores the rare occurrence of simultaneous ischemic stroke and myocardial infarction due to malignancy-associated DIC in metastatic prostate cancer, highlighting the need for early recognition and balanced management of thrombosis and bleeding.
Pattanayak et al. (Mon,) reported a other. Disseminated intravascular coagulation in metastatic prostate cancer can rarely present with simultaneous acute ischemic stroke and myocardial infarction alongside severe bleeding.