<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>BACKGROUND</h3>
<p>Acute myocardial infarction (MI) is a rare occurrence in patients under 40 years of age without positive family history for coronary artery disease (CAD). Genetic conditions as inherited thrombophilia can lead to a hypercoagulable state, resulting in thromboembolic events and arterial thrombosis.</p>
</sec>
<sec><h3>CASE SUMMARY</h3>
<p>We present a case of a 35-year-old male patient who presented to the emergency room with an inferior MI after a strenuous cycling exercise. An urgent coronary angiography showed thrombotic formations in the right coronary artery without atherosclerotic plaques. Plain old balloon angioplasty and thrombus aspiration were performed, which was followed by GP IIb/IIIa inhibitor infusion and unfractionated heparin for 24 h. From past medical history, the patient had COVID-19 like symptoms 20 days before the event and had his first dose of anti-COVID vaccine 2 weeks prior. After additional testing, molecular genetic analysis results revealed the patient to be heterozygous for factor V Leiden (FVL) and homozygous for methylenetetrahydrofolate reductase C677T gene mutation. The patient was discharged on direct oral anticoagulant and antiplatelet therapy. After 1-year follow-up, he had no symptoms or recurrent cardiovascular events.</p>
</sec>
<sec><h3>CONCLUSION</h3>
<p>Inherited thrombophilia is а significant risk factor for CAD and performing genetic testing in younger patients with a cardiovascular event and plays an important role for adequate treatment and prophylaxis from recurrent complications. The use of oral anticoagulation for prophylaxis is shown to be effective in these patients. However, further studies are needed to prove their exact role and duration of treatment.</p>
</sec>
</abstract>

BACKGROUND
Acute myocardial infarction (MI) is a rare occurrence in patients under 40 years of age without positive family history for coronary artery disease (CAD). Genetic conditions as inherited thrombophilia can lead to a hypercoagulable state, resulting in thromboembolic events and arterial thrombosis.

CASE SUMMARY
We present a case of a 35-year-old male patient who presented to the emergency room with an inferior MI after a strenuous cycling exercise. An urgent coronary angiography showed thrombotic formations in the right coronary artery without atherosclerotic plaques. Plain old balloon angioplasty and thrombus aspiration were performed, which was followed by GP IIb/IIIa inhibitor infusion and unfractionated heparin for 24 h. From past medical history, the patient had COVID-19 like symptoms 20 days before the event and had his first dose of anti-COVID vaccine 2 weeks prior. After additional testing, molecular genetic analysis results revealed the patient to be heterozygous for factor V Leiden (FVL) and homozygous for methylenetetrahydrofolate reductase C677T gene mutation. The patient was discharged on direct oral anticoagulant and antiplatelet therapy. After 1-year follow-up, he had no symptoms or recurrent cardiovascular events.

CONCLUSION
Inherited thrombophilia is а significant risk factor for CAD and performing genetic testing in younger patients with a cardiovascular event and plays an important role for adequate treatment and prophylaxis from recurrent complications. The use of oral anticoagulation for prophylaxis is shown to be effective in these patients. However, further studies are needed to prove their exact role and duration of treatment.

A Curious Case of Acute STEMI in a Young Patient; Things are Not Always What They Seem

South East European Journal of Cardiology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BACKGROUND
Acute myocardial infarction (MI) is a rare occurrence in patients under 40 years of age without positive family history for coronary artery disease...

A Curious Case of Acute STEMI in a Young Patient; Things are Not Always What They Seem

Published Online: Dec 25, 2023

Page range: 36 - 39

Received: May 02, 2023

Accepted: Jul 19, 2023

DOI: https://doi.org/10.3889/seejca.2023.6047

Keywords
Factor V Leiden mutation, Methylenetetrahydrofolate reductase gene mutation, Myocardial infarction, COVID-19 infection

© 2023 Elif Vraynko et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

A Curious Case of Acute STEMI in a Young Patient; Things are Not Always What They Seem

Published Online: Dec 25, 2023

Page range: 36 - 39

Received: May 02, 2023

Accepted: Jul 19, 2023

DOI: https://doi.org/10.3889/seejca.2023.6047

KeywordsFactor V Leiden mutation, Methylenetetrahydrofolate reductase gene mutation, Myocardial infarction, COVID-19 infection

© 2023 Elif Vraynko et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Factor V Leiden mutation, Methylenetetrahydrofolate reductase gene mutation, Myocardial infarction, COVID-19 infection