December 19, 2011 by staff
Myocardial Infarction, IntroductionCongenital fibrinogen deficiency is a rare coagulation disorder usually responsible for hemorrhagic diathesis. However, it can be associated with thrombosis and there have been limited reports of arterial thrombotic complications in these patients.Case presentationA 42-year-old Tunisian man with congenital hypofibrinogenemia and no cardiovascular risk factors presented with new onset prolonged angina pectoris.
An electrocardiogram showed features of inferior acute myocardial infarction. His troponin levels had reached 17ng/L.
Laboratory findings confirmed hypofibrinogenemia and ruled out thrombophilia. Echocardiography was not useful in providing diagnostic elements but did show preserved left ventricular function.
Coronary angiography was not performed and our patient did not receive any anticoagulant treatment due to the major risk of bleeding. Magnetic resonance imaging confirmed myocardial necrosis.
Our patient was managed with aspirin, a beta-blocker, an angiotensin-converting enzyme inhibitor and statin medication. The treatment was well tolerated and no ischemic recurrence was detected.
Conclusion: Although coronary thrombosis is a rare event in patients with fibrinogen deficiency, this condition is of major interest in view of the difficulties observed in managing these patients.
Author: Fathia MghaiethHabiba MizouniSihem MbarkiJihen AyariRamy TrabelsiNidhal Ben MoussaMohamed Sami MouraliEmna MnifRachid Mechmeche
Credits/Source: Journal of Medical Case Reports 2011, 5:582
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