Management of leiomyoma causing myocardial infarction

Although most myocardial infarctions are caused by either obstruction or spasm of the coronary arteries, severe anemia can lower oxygen carrying capacity and damage the myocardium. We report a case of leiomyoma-induced menorrhagia of such severity that myocardial infarction ensued. Hysterectomy was indicated to avoid further anemia. While delaying elective surgery until the heart has had time to recover from infarction is the usual practice, the fact that myoma-induced menorrhagia contributed to ischemia in this patient prompted us to perform hysterectomy shortly after infarction.