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. 2002 Jun;94(6):448–452.

Myocardial infarction in sickle cell disease.

Ishak A Mansi 1, Fred Rosner 1
PMCID: PMC2594394  PMID: 12078925

Abstract

Vasculo-occlusive crisis with organ infarctions occur in sickle cell disease (SCD). However, heart infarction is not commonly reported. We reviewed 19 cases of documented myocardial infarction (MI) in SCD patients. The true incidence may be higher because the diagnosis was often made at autopsy and was overshadowed during life by other musculoskeletal symptoms. Electrocardiography is frequently unhelpful. Skeletal muscle enzymes confound serum cardiac enzyme interpretation. The mechanism of MI in SCD is not exactly known, as coronary angiography is usually normal. MI frequently occurs in association with hypoxia, cor pulmonale, anemia, sepsis, acidosis, and renal failure. The aim of this article is to increase awareness for this complication and to prompt prospective studies to look at treatment strategies for myocardial infarction in SCD.

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Selected References

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  1. Baroldi G. High resistance of the human myocardium to shock and red blood cell aggregation (sludge). Cardiologia. 1969;54(5):271–277. doi: 10.1159/000166261. [DOI] [PubMed] [Google Scholar]
  2. Barrett O., Jr, Saunders D. E., Jr, McFarland D. E., Humphries J. O. Myocardial infarction in sickle cell anemia. Am J Hematol. 1984 Feb;16(2):139–147. doi: 10.1002/ajh.2830160206. [DOI] [PubMed] [Google Scholar]
  3. Botreau-Roussel P., Drobinski G., Lévy R., Vachon J. M., Nivet M., Grosgogeat Y. Infarctus du myocarde et drépanocytose hétérozygote. A propos de 2 cas. Arch Mal Coeur Vaiss. 1977 Feb;70(2):141–147. [PubMed] [Google Scholar]
  4. Brittain H. A., Eckman J. R., Swerlick R. A., Howard R. J., Wick T. M. Thrombospondin from activated platelets promotes sickle erythrocyte adherence to human microvascular endothelium under physiologic flow: a potential role for platelet activation in sickle cell vaso-occlusion. Blood. 1993 Apr 15;81(8):2137–2143. [PubMed] [Google Scholar]
  5. Charache S. Sudden death in sickle trait. Am J Med. 1988 Mar;84(3 Pt 1):459–461. doi: 10.1016/0002-9343(88)90266-5. [DOI] [PubMed] [Google Scholar]
  6. Chien S., Usami S., Bertles J. F. Abnormal rheology of oxygenated blood in sickle cell anemia. J Clin Invest. 1970 Apr;49(4):623–634. doi: 10.1172/JCI106273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. De Franceschi L., Bachir D., Galacteros F., Tchernia G., Cynober T., Neuberg D., Beuzard Y., Brugnara C. Oral magnesium pidolate: effects of long-term administration in patients with sickle cell disease. Br J Haematol. 2000 Feb;108(2):284–289. doi: 10.1046/j.1365-2141.2000.01861.x. [DOI] [PubMed] [Google Scholar]
  8. Freedman M. L., Karpatkin S. Elevated platelet count and megathrombocyte number in sickle cell anemia. Blood. 1975 Oct;46(4):579–582. [PubMed] [Google Scholar]
  9. Gerry J. L., Bulkley B. H., Hutchins G. M. Clinicopathologic analysis of cardiac dysfunction in 52 patients with sickle cell anemia. Am J Cardiol. 1978 Aug;42(2):211–216. doi: 10.1016/0002-9149(78)90902-5. [DOI] [PubMed] [Google Scholar]
  10. Gordon P. A., Breeze G. R., Mann J. R., Stuart J. Coagulation fibrinolysis in sickle-cell disease. J Clin Pathol. 1974 Jun;27(6):485–489. doi: 10.1136/jcp.27.6.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Harlan J. M. Introduction: anti-adhesion therapy in sickle cell disease. Blood. 2000 Jan 15;95(2):365–367. [PubMed] [Google Scholar]
  12. Hebbel R. P. Perspectives series: cell adhesion in vascular biology. Adhesive interactions of sickle erythrocytes with endothelium. J Clin Invest. 1997 Jun 1;99(11):2561–2564. doi: 10.1172/JCI119442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hossein-Nia M., Nisbet J., Merton G. K., Holt D. W. Spurious rises of cardiac troponin T. Lancet. 1995 Dec 9;346(8989):1558–1558. doi: 10.1016/s0140-6736(95)92087-0. [DOI] [PubMed] [Google Scholar]
  14. James T. N. Homage to James B. Herrick: a contemporary look at myocardial infarction and at sickle-cell heart disease: the 32nd Annual Herrick Lecture of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2000 Apr 18;101(15):1874–1887. doi: 10.1161/01.cir.101.15.1874. [DOI] [PubMed] [Google Scholar]
  15. James T. N., Riddick L., Massing G. K. Sickle cells and sudden death: morphologic abnormalities of the cardiac conduction system. J Lab Clin Med. 1994 Oct;124(4):507–520. [PubMed] [Google Scholar]
  16. Johnson W. H., Jr, McCrary R. B., Mankad V. N. Transient left ventricular dysfunction in childhood sickle cell disease. Pediatr Cardiol. 1999 May-Jun;20(3):221–223. doi: 10.1007/s002469900447. [DOI] [PubMed] [Google Scholar]
  17. Karayalcin G., Rosner F., Kim K. Y., Chandra P., Aballi A. J. Sickle cell anemia- clinical manifestations in 100 patients and review of the literature. Am J Med Sci. 1975 Jan-Feb;269(1):51–68. doi: 10.1097/00000441-197501000-00007. [DOI] [PubMed] [Google Scholar]
  18. Koate P. Pathologie cardiovasculaire dans la drépanocytose. Bull Acad Natl Med. 1991 Oct;175(7):1055–1063. [PubMed] [Google Scholar]
  19. Mansi I. A., Alkhunaizi A. M., Al-Khatti A. A. Bilateral central retinal artery occlusion secondary to sickle cell disease. Am J Hematol. 2000 May;64(1):79–80. doi: 10.1002/(sici)1096-8652(200005)64:1<79::aid-ajh18>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  20. Martin C. R., Cobb C., Tatter D., Johnson C., Haywood L. J. Acute myocardial infarction in sickle cell anemia. Arch Intern Med. 1983 Apr;143(4):830–831. [PubMed] [Google Scholar]
  21. Martin C. R., Johnson C. S., Cobb C., Tatter D., Haywood L. J. Myocardial infarction in sickle cell disease. J Natl Med Assoc. 1996 Jul;88(7):428–432. [PMC free article] [PubMed] [Google Scholar]
  22. McCormick W. F. Massive nonatherosclerotic myocardial infarction in sickle cell anemia. Am J Forensic Med Pathol. 1988 Jun;9(2):151–154. doi: 10.1097/00000433-198806000-00012. [DOI] [PubMed] [Google Scholar]
  23. Norris S., Johnson C. S., Haywood L. J. Sickle cell anemia: does myocardial ischemia occur during crisis? J Natl Med Assoc. 1991 Mar;83(3):209–213. [PMC free article] [PubMed] [Google Scholar]
  24. Powars D. R. Sickle cell anemia and major organ failure. Hemoglobin. 1990;14(6):573–598. doi: 10.3109/03630269009046967. [DOI] [PubMed] [Google Scholar]
  25. Rubler S., Fleischer R. A. Sickle cell states and cardiomyopathy. Sudden death due to pulmonary thrombosis and infarction. Am J Cardiol. 1967 Jun;19(6):867–873. doi: 10.1016/0002-9149(67)90510-3. [DOI] [PubMed] [Google Scholar]
  26. Saad S. T., Arruda V. R., Junqueira O. O., Schelini F. A., Coelho O. B. Acute myocardial infarction in sickle cell anaemia associated with severe hypoxia. Postgrad Med J. 1990 Dec;66(782):1068–1070. doi: 10.1136/pgmj.66.782.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Space S. L., Lane P. A., Pickett C. K., Weil J. V. Nitric oxide attenuates normal and sickle red blood cell adherence to pulmonary endothelium. Am J Hematol. 2000 Apr;63(4):200–204. doi: 10.1002/(sici)1096-8652(200004)63:4<200::aid-ajh7>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  28. Sullivan K. J., Goodwin S. R., Evangelist J., Moore R. D., Mehta P. Nitric oxide successfully used to treat acute chest syndrome of sickle cell disease in a young adolescent. Crit Care Med. 1999 Nov;27(11):2563–2568. doi: 10.1097/00003246-199911000-00039. [DOI] [PubMed] [Google Scholar]
  29. UZSOY N. K. CARDIOVASCULAR FINDINGS IN PATIENTS WITH SICKLE CELL ANEMIA. Am J Cardiol. 1964 Mar;13:320–328. doi: 10.1016/0002-9149(64)90447-3. [DOI] [PubMed] [Google Scholar]
  30. de Pontual L., Acar P., de Montalembert M., Villain E., Maunoury C., Sidi D., Kachaner J. L'ischémie myocardique: une complication méconnue de la drépanocytose chez l'enfant. A propos de deux observations. Arch Pediatr. 1999 Feb;6(2):178–181. doi: 10.1016/s0929-693x(99)80206-1. [DOI] [PubMed] [Google Scholar]

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