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November 1971

Coronary Artery Occlusion Due to Neoplasm: A Rare Cause of Acute Myocardial Infarction

Author Affiliations

Washington, DC

From the departments of medicine and pathology, Washington Hospital Center, Washington, DC. Dr. Franciosa is now with the Veterans Administration Hospital, Washington.

Arch Intern Med. 1971;128(5):797-801. doi:10.1001/archinte.1971.00310230127015

Coronary atherosclerosis accounts for virtually all cases of myocardial infarction. On rare occasions other processes may involve the coronary arteries. Anomalous origin, aneurysm, and arteriovenous fistula occur in these vessels.1-3 Embolization due to bacterial endocarditis, mural thrombi, or during cardiac surgery are well-known phenomena, and thrombosis may occur in patients with hematologic disorders such as polycythemia and sickle-cell anemia. Aortic dissection, infection, collagen-vascular disease, rheumatic fever, amyloidosis, gout, and Buerger's disease have also been reported to involve the coronary arteries.4-7

Neoplastic disease also involves the heart; when coronary vessels are affected, ischemia or infarction may result. While this possibility is well recognized in theory, actual cases are apparently exceedingly rare. At Washington Hospital Center from 1958 through 1968, 892 cases of myocardial infarction have come to autopsy. Three of these had the combination of epicardial or myocardial metastases or both and recent infarctions associated with coronary atherosclerosis. In

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