Acute ST-Segment Elevation Myocardial Infarction in a Patient with Beta Thalassemia / Hemoglobin E
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Abstract
Acute myocardial infarction (AMI) has been very rare in beta thalassemia and has never been seen in the patients with beta-thalassemia/hemoglobin E. Herein we report acase of 38-year-old Thai man with underlying transfusion-dependent beta-thalassemia/Hb E disease which is proved by the genotype study. Other concurrent morbidities are the low LDL, low HDL, secondary hemosiderosis and hypogonadism. He presents with acute chest tightness and heaviness during watching the television. He is definitely diagnosed as acute ST segment elevation MI of infero-lateral wall based on the history of the acute chest discomfort, the elevation of ST segment on ECG and increased cardiac enzymes. The immediate cardiac catheterization demonstrates the white thrombus completely occluding the LAD and the LCX. He completely recovers from acute MI after the immediate treatment with the percutaneous coronary intervention (PCI) with simultaneousthrombolytic therapy. The established risk factors for CAD cannot be identified in our case except for the low HDL while the attributing factors such as high platelet countafter splenectomy, high serum ferritin and low serum testosterone are proposed.
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