Journal of Thrombosis and Thrombolysis

, Volume 47, Issue 1, pp 157–161 | Cite as

Coronary thrombosis in acute pancreatitis

  • Saagar Sanghvi
  • Fahad WaqarEmail author
  • Mohamed Effat


The incidence of acute myocardial infarction in the setting of acute pancreatitis is very rare. The recognition of such complex diagnosis may be clinically challenging, as the symptoms of both conditions are often indistinguishable. We report a case in which we encountered both conditions concurrently, and hypothesize that the ambient inflammatory and pro-thrombotic milieu of acute pancreatitis resulted in acute coronary thrombosis despite the absence of significant coronary atherosclerosis. Among multiple coronary imaging modalities currently in use, optimal cohesion tomography provided a unique capability for direct visualization of the coronary thrombus. (1) Inflammatory processes such as acute pancreatitis promote a thrombogenic state. (2) Presentation of acute myocardial infarction is variable and can mimic a variety of medical conditions. (3) Intravascular imaging is emerging as a useful tool in delineating details of intra-coronary pathology not clear on standard fluoroscopy. (4) The above case highlights the likely concurrence of pathologies that follow common pathways such as system-wide inflammation and coagulation. Clinicians must be aware of this uncommon yet very likely possibility and keep a low threshold to perform ECG and cardiac biomarker testing if symptoms are suggestive of a myocardial infarction, even in the presence of a clear alternative diagnosis.


Coronary thrombosis Acute pancreatitis Acute myocardial infarction 


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA
  2. 2.Division of Cardiovascular Health and Disease, Department of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA

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