Afibrinogenaemia

A rare cause of young myocardial infarct

Naresh Kumar, R. Padma Kumar, B. Ramesh, N. Garg

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Afibrinogenaemia is a quantitative deficiency of fibrinogen that is associated with an increased bleeding tendency. Patients with afibrinogenaemia are at risk of excessive bleeding, but unusually, these patients may also experience thrombotic episodes. We report a 27-year-old man, with a known history of afibrinogenaemia, and who presented with acute onset of chest pain. Clinical examination was normal. Electrocardiogram revealed features suggestive of inferior and right ventricular myocardial infarction. This diagnosis was confirmed on echocardiogram, and by the elevated levels of cardiac enzymes troponin T and Creatinine kinase-MB. In view of the existing afibrinogenaemia, thrombolytics and anticoagulants were not given. He was managed with antiplatelets, nitrates, statins and angiotensin converting enzyme inhibitors. Young coronary artery disease risk factors (including thrombophilia) were otherwise normal. The patient tolerated dual antiplatelet therapy without any bleeding. The thrombotic episode occurring in tandem with the afibrinogenaemia, as have been observed in previous reports, is likely to be the cause for acute myocardial infarction in our patient.

Original languageEnglish
JournalSingapore Medical Journal
Volume49
Issue number4
Publication statusPublished - 01-04-2008
Externally publishedYes

Fingerprint

Afibrinogenemia
Myocardial Infarction
Hemorrhage
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Troponin T
Thrombophilia
Chest Pain
Angiotensin-Converting Enzyme Inhibitors
Nitrates
Anticoagulants
Coronary Artery Disease
Creatinine
Electrocardiography
Phosphotransferases
Enzymes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kumar, N., Padma Kumar, R., Ramesh, B., & Garg, N. (2008). Afibrinogenaemia: A rare cause of young myocardial infarct. Singapore Medical Journal, 49(4).
Kumar, Naresh ; Padma Kumar, R. ; Ramesh, B. ; Garg, N. / Afibrinogenaemia : A rare cause of young myocardial infarct. In: Singapore Medical Journal. 2008 ; Vol. 49, No. 4.
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Kumar, N, Padma Kumar, R, Ramesh, B & Garg, N 2008, 'Afibrinogenaemia: A rare cause of young myocardial infarct', Singapore Medical Journal, vol. 49, no. 4.

Afibrinogenaemia : A rare cause of young myocardial infarct. / Kumar, Naresh; Padma Kumar, R.; Ramesh, B.; Garg, N.

In: Singapore Medical Journal, Vol. 49, No. 4, 01.04.2008.

Research output: Contribution to journalArticle

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T2 - A rare cause of young myocardial infarct

AU - Kumar, Naresh

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AU - Ramesh, B.

AU - Garg, N.

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AB - Afibrinogenaemia is a quantitative deficiency of fibrinogen that is associated with an increased bleeding tendency. Patients with afibrinogenaemia are at risk of excessive bleeding, but unusually, these patients may also experience thrombotic episodes. We report a 27-year-old man, with a known history of afibrinogenaemia, and who presented with acute onset of chest pain. Clinical examination was normal. Electrocardiogram revealed features suggestive of inferior and right ventricular myocardial infarction. This diagnosis was confirmed on echocardiogram, and by the elevated levels of cardiac enzymes troponin T and Creatinine kinase-MB. In view of the existing afibrinogenaemia, thrombolytics and anticoagulants were not given. He was managed with antiplatelets, nitrates, statins and angiotensin converting enzyme inhibitors. Young coronary artery disease risk factors (including thrombophilia) were otherwise normal. The patient tolerated dual antiplatelet therapy without any bleeding. The thrombotic episode occurring in tandem with the afibrinogenaemia, as have been observed in previous reports, is likely to be the cause for acute myocardial infarction in our patient.

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Kumar N, Padma Kumar R, Ramesh B, Garg N. Afibrinogenaemia: A rare cause of young myocardial infarct. Singapore Medical Journal. 2008 Apr 1;49(4).