We describe a 54-year-old man who was HIV-positive, admitted for cardiogenic shock complications inferior myocardial infarction. He was treated with primary percutaneous transluminal angioplasty (PCTA) and stent deployment in mid right coronary artery. After a few days thrombotic occlusion of the stent occurred, and the problem recurred during implantation of a new stent in the course of a second PTCA. We detected coinheritance of factor V Leiden, primary antiphospholipid syndrome and antithrombin deficiency. We discuss the role of these coagulation disorders in acute myocardial infarction as well as the treatment and course of the coronary syndrome in this context.
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Silent myocardial infarction (SMI) is a type of myocardial infarction that occurs in the absence of, or with, minimal symptoms, often leading to a delay in medical treatment. There is a lack of data regarding the incidence and/or prevalence of a left ventricular (LV) thrombus in those who have had an SMI, due to the rarity of such cases. We describe a case of an SMI with LV thrombus in an otherwise healthy young man, whose first presentation was with stroke-type symptoms and who was also later found to have a Factor V Leiden (FVL) mutation and raised factor VIII levels.
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