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Acute Non-Atherosclerotic ST-Segment Elevation Myocardial Infarction in an Adolescent with Concurrent Hemoglobin

Ekarat Rattarittamrong1, Lalita Norasetthada1, Adisak Tantiworawit1

  • 1Division of Hematology, Department of Internal Medicine.

Hematology Reports
|October 22, 2015
PubMed

Insights

Polycythemia vera (PV) and hemoglobin H-Constant Spring disease can increase thrombosis risk. Early diagnosis and treatment of PV in thalassemia patients with high platelets are crucial for preventing heart attacks.

Area of Science:

  • Hematology
  • Cardiology
  • Genetics

Background:

  • Thrombosis is a significant complication in both polycythemia vera (PV) and thalassemia.
  • JAK2 V617F mutation is a common driver in PV, associated with increased thrombotic risk.

Observation:

  • A 17-year-old male with post-splenectomized hemoglobin H-Constant Spring disease and JAK2 V617F-positive PV presented with extreme thrombocytosis (platelets > 1,000,000/µL).
  • Three months later, he experienced an ST-segment elevation myocardial infarction (STEMI) due to an acute coronary artery clot without atherosclerotic plaque.

Findings:

  • The patient was treated with plateletpheresis, hydroxyurea, and antiplatelet agents.
  • Treatment led to a decrease in platelet count and improvement in symptoms.

Implications:

  • This case highlights the critical need for early diagnosis and management of PV in patients with underlying thalassemia and marked thrombocytosis.
  • Awareness of heightened thrombotic risk in such patients is essential for preventing severe cardiovascular events like STEMI.

Keywords:
Polycythemia verahemoglobin H diseasehemoglobin H-Constant Spring diseasemyocardial infarctionthalassemia

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