Myocardial infarction and thrombophilia: Do not miss the right diagnosis!

Arnaud Hubert (1, 2) , Pierre Guéret (3) , Guillaume Leurent (2) , Raphael P. Martins (1, 2) , Vincent Auffret (1, 2) , Marc Bedossa (1, 2)

1 LTSI - Laboratoire Traitement du Signal et de l'Image
2 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
3 CHU Pontchaillou [Rennes]

Protein C deficiency is a coagulation cascade disorder often resulting in venous thromboembolic events but is also a possible contributor to arterial thrombosis. To date, approximately ten cases of myocardial infarction (MI) due to protein C deficiency have been reported in the literature. However, affirming this mechanism requires ruling out the most common causes of MI, i.e. the rupture or erosion of an atherosclerotic plaque. Intravascular imaging of coronary arteries can be of help to identify angiographically undetected atherosclerosis. We report a case of an ST-segment elevation myocardial infarction (STEMI) in a young man with apparent evidence of arterial thrombosis resulting from protein C deficiency and heterozygous factor Leiden mutation which was contradicted by intravascular imaging demonstrating atherosclerosis.

Keywords: Atherosclerosis; Intravascular ultrasound; Thrombophilia; Coronary thrombosis; Platelet aggregation inhibitors; Myocardial infarction

Domains: Life Sciences [q-bio]; Human health and pathology; Cardiology and cardiovascular system; Life Sciences [q-bio]; Bioengineering; Imaging

Arnaud Hubert, Pierre Guéret, Guillaume Leurent, Raphael P. Martins, Vincent Auffret, et al.. Myocardial infarction and thrombophilia: Do not miss the right diagnosis!. Revista Portuguesa de Cardiología, 2018, 37 (1), pp.89.e1-89.e4. ⟨10.1016/j.repc.2016.12.018⟩. ⟨hal-01718027⟩