Coronary hearth disease is a significant cause of mortality and morbidity at mature ages. Diabettes mellitus, hyper-tension, hyper-lipidemia, and metabolic syndrome are important risk factors. Germ cell tumors of testicle constitute a large portion of all of the testicle tumors. The sisplatin based chemotherapies used in germ cell tumors, even though being uncommon, has the risk of causing acute vascular trombus. We presented a case who took sisplatin based chemotherapy up on testicle germ cell tumor and developed acute inferior miyocard infarction due to RCA trombus after one day. Twenty eight year old male patient consulted our clinic up on severe chest ache and dyspnea. In his story, he was using BEP (Bleomycin, Etoposide, Sisplatin) chemotherapy due to GCT. The patient had not got diabetus, hypertension and hyperlipidemia history. In his family history also, there were no risk factors for coronary artery disease. He had taken his second cure of chemotherapy one day before. The findings in physical examination was un remarkable. The electrocardiography showed that in sinus rhythm and there was a ST elevation of 3 to 4 mm at D2, D3, AVF. Urgent coronary intervention was planned for the patient. Thrombosis near to total was observed at coronary angiography (Figure-1). Thrombus aspiration was performed by intervention (Figure-2). Bare metal stent (Ephesos; 4,5 x 12 mm) was implanted to RCA proximal. His clinical follow up was uneventful,charged by medical treatment.
One of the most important side effects of sisplatin based regimes used in Germ Cell Tumors is vascular toxicity. For such patients, the thrombo-embolic risk must be reviewed before commencing the treatment and if necessary the patient must be reassessed for anti-coagulation and anti-aggregation.
