Key result
Percutaneous coronary intervention with thrombus aspiration and stenting completely resolved persistent hiccups within 24 hours in a 46-year-old man with acute proximal LAD thrombosis.
Why the study?
Hiccups are usually benign and self-limited, but when persistent they may be a marker of serious medical conditions such as acute myocardial infarction.
Case Report (n=1)
No
Persistent hiccups can be a rare atypical presentation of acute proximal LAD thrombosis, which resolves following successful revascularization.
Persistent hiccups may rarely signal acute LAD occlusion; this single case leaves open whether ischemia evaluation is warranted for unexplained symptoms.
INTRODUCTION: Hiccup is usually a benign and self-limited phenomenon. Therefore, if hiccups do not resolve by themselves and even last for a long time, it may be the marker of serious medical conditions. PATIENT CONCERNS: We encountered a case presenting with recurrent abdominal discomfort. Diffuse ST-segment elevation in V2-V6 and elevated Troponin I was identified. He had complained about constipation and incomplete intestinal obstruction was ever suspected. Four days later, he exhibited persistent hiccups. DIAGNOSIS: He was diagnosed with acute anterior wall myocardial infarction. And elective coronary angiography showed that proximal left anterior descending (LAD) was occluded by fresh thrombus with TIMI 1 flow. INTERVENTIONS: The lesion in proximal LAD was dilated with low pressure. Interestingly, the hiccups reduced. And after stent implantation the hiccup disappeared in 24 hours. OUTCOMES: The patient was discharged in good general condition, with maintenance therapy and a follow-up protocol. CONCLUSION: Hiccup is only rarely described in the context of acute proximal LAD thrombosis. However, if this special symptom occurs intractably during disease progression, thrombus is revealed to be the probable cause, prompt opening of the criminal vessel should be performed besides strengthening of anticoagulant and antiplatelet.
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Gao et al. (2019) conducted a case report in Acute myocardial infarction with proximal LAD thrombosis (n=1). Percutaneous coronary intervention was evaluated on Resolution of hiccups. Percutaneous coronary intervention with thrombus aspiration and stenting completely resolved persistent hiccups within 24 hours in a 46-year-old man with acute proximal LAD thrombosis.
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