Incidence of Iliopsoas Muscle Hematoma During Treatment of Acute Myocardial Infarction with Antiplatelet and Anticoagulant Agents

• Published in: JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE Vol. 61; no. 4; pp. 636 - 642
• Main Authors: ASADA, Kaoru, KAMIYA, Yasutaka, OHKOUCHI, Masahiro, IWAMA, Tadashi, HATTORI, Kouhei, GOUJI, Shigeki, SAKURAI, Ayako, KATSUNO, Tetsuya, YAMAMOTO, Youichi, NAGANAWA, Hirokazu, GOTO, Akitomo, OHNO, Tsuneo
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE ASSOCIATION OF RURAL MEDICINE 2013
• ISSN: 0468-2513; 1349-7421
• DOI: 10.2185/jjrm.61.636

On July 7, 2010, a 74-year-old man came to our hospital, complaining that he had a nagging pain in his chest that started the preceding day. After performing electrocardiography, blood tests and electrocardiography, we diagnosed the case as acute myocardial infarction. At first, it was thought that blood flow could be restored in due course of time, antiplatelet and anticoagulant agents were used. Intracardiac catheterization was not included in our initial treatment plan. Three days after the initiation of the treatment, the patient had pain in his left inguinocrural region. Computed tomography and magnetic resonance imaging reveled hematoma in his left iliopsoas muscle. We stopped administering antiplatelet and anticoagulant agents to him. But anemia progressed from Hb14.1g/dL to 9.8 g/dL, so blood transfusions had to be given. After that, the patient underwent a rest cure. With the passage of time, the pain and swelling of the left iliopsoas muscle went down. Regarding the cardiac condition, however, the pain in the chest did not abate even when he was taking a rest. The antiplatelet therapy was resumed, with one type of agent given at first and then with another type added. Examinations using a coronary CT and a cadiac catheter found 90% stenosis at the proximal left anterior descending coronary artery. So, a bare metal stent was placed in the near-closed artery. Ever since, there has been no recrudescence of chest pain and no recurrence of iliopsoas muscle hematoma. The extravascated blood mass seemed to be dissolved spontaneously.