A 64-year-old man suffering from ST-elevation myocardial infarction and severe thrombocytopenia: Procedures in the case of a patient not fitting the guidelines.

The objective of this case report is to present how the chronic condition significantly complicates life-saving procedures and influences further treatment decisions. A 64-year-old man suffering from arterial hypertension and immune thrombocytopenic purpura presented to the Emergency Department with anterior ST-elevation myocardial infarction. An immediate coronary angiography was performed where critical stenosis of the proximal left anterior descending was found.

Perforation of saphenous vein graft with mediastinal haemorrhage leading to near closure of distal graft segment.

Perforations of saphenous venous grafts during coronary angioplasty are rare and potentially lethal. The objective of this clinical case report is to highlight this unusual complication and necessary treatment. A 76-year-old woman, 3 months after coronary artery bypass grafting (left internal mammary artery to left anterior descendant artery, saphenous vein graft to obtuse marginal, saphenous vein graft to right coronary artery), demonstrated typical signs of acute coronary syndrome.