Korean J Med.  2010 Mar;78(3):364-369.

Acute myocardial infarction coincident with gastric ulcer bleeding following herbal medication-induced acute renal failure

• Kang KW
• Lee KJ
• Yoon HS
• Cho YS
• Kim SB
• Lee S
• Jung SH

Abstract

Acute renal failure, acute myocardial infarction (AMI), and gastric ulcer bleeding (GUB) are associated with high rates of morbidity and mortality, especially in older patients. The development of each of these conditions can be followed by the development of another; however, it is rare for these three conditions to develop concurrently. Here, we report the case of a 92-year-old man who was admitted because of generalized weakness that developed after the ingestion of nothing but functional foods, including herbal medications containing Glycyrrhiza and Aloe, for ten days. After admission, AMI and GUB developed approximately six hours apart. Conservative treatment was chosen for the bleeding ulcer because of the high procedural risk, and the use of antiplatelet agents and heparinization for treatment of the infarction were stopped. The patient remained hemodynamically stable following the administration of a statin, diuretics, and proton pump inhibitors. A healed scar at the site of the ulcer was confirmed three weeks later; however, postinfarct angina developed after the patient's last endoscopy. Percutaneous coronary intervention was successfully performed with two stents placed in the left anterior descending artery.

Keyword

Acute renal failure; Acute myocardial infarction; Gastric ulcer bleeding; Herbal medication

MeSH Terms

Acute Kidney Injury
Aloe
Arteries
Cicatrix
Diuretics
Eating
Endoscopy
Functional Food
Glycyrrhiza
Hemorrhage
Heparin
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Infarction
Myocardial Infarction
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors
Proton Pump Inhibitors
Stents
Stomach Ulcer
Ulcer
Diuretics
Heparin
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Platelet Aggregation Inhibitors
Proton Pump Inhibitors