Localized Treatment of Chest Pain is Still Common in Rural Areas

Description This is the case of a 45-year-old man with documented coronary artery disease, who refused a referral for coronary artery bypass grafting surgery (CABG) and preferred instead to seek leech therapy (Figure 1). The second course of leech application resulted in the patient’s becoming severely symptomatic and suffering myocardial infarction, for which he was referred to our center. In the laboratory findings of the patient, hemoglobin was low, and prothrombin time, international normalized ratio, and partial thromboplastin time had markedly risen. Leeches have been in use for centuries to treat a wide range of ailments.1 Nowadays, leeches are used successfully for only a few conditions.2 Optimal care is needed when applying leeches because their use can be complicated by serious complications such as bacterial infections, anemia, and coagulation disorder.3 Our patient was hospitalized in the CCU; and after hematology consultation and correction of his coagulopathy abnormalities, he underwent CABG. Now he is stable through treatment, with an ejection fraction of about 35%.