Myocardial infarction in patients with severe beta thalassaemia: a case series

Myocardial infarction in patients with severe beta thalassaemia: a case series

Cardiac disease remains a dominant if not the most important cause of morbidity and mortality

Background Cardiac disease remains a dominant if not the most important cause of morbidity and mortality in
patients with thalassaemia, particularly in those with thalassaemia major. Myocardial infarction and coronary artery
disease however are rarely reported.
Case presentations Three older patients with three distinct thalassaemia syndromes presented with acute coronary
syndrome. Two were heavily transfused whilst the other was a minimally transfused patient. Both heavily transfused
patients had ST-elevation myocardial infarctions (STEMI) while the minimally transfused patient had unstable angina.
Coronary angiogram (CA) was normal in two patients. One patient who developed a STEMI had a 50% plaque. All
three were managed as standard ACS, although the aetiology appeared non-atherogenic.
Conclusions The exact etiology of the presentation, remains a mystery and therefore the rational use of thrombolytic
therapy, carrying out angiogram in the primary setting, using and continuing antiplatelet and high dose statins all
remains unclear in this sub group of patients.

Anuja Premawardhena1*, Shamila De Silva1

, Megha Rajapaksha2

, Vishaka Ratnamalala3
,

Jemimah Nallarajah4 and Gamini Galappatthy4

https://doi.org/10.1186/s12245-023-00495-z

2023

peri irawan

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