Key result
A 24-year-old male with nephrotic syndrome developed an acute STEMI due to a complete acute occlusion of the proximal left anterior descending artery, likely driven by a hypercoagulable state.
Why the study?
Acute myocardial infarction is uncommon in young males, and thromboembolism caused by nephrotic syndrome represents one potential pathophysiology.
Case Report (n=1)
Nephrotic syndrome can induce a hypercoagulable state leading to acute STEMI, and should be considered as a contributing factor in young patients presenting with myocardial infarction.
Consider nephrotic syndrome in young STEMI patients; this case leaves open the causal role of hypercoagulability.
Background: In young males, an acute myocardial infarction is an uncommon event. Thrombolism caused by nephrotic syndrome (NS) is one of the pathophysiologies of their infarctions. Case Illustration: A-24-y.o male patient, presenting with prolong typical chest pain since 72 hours before admission. The chest leads on an electrocardiogram (ECG) indicated ST-Elevation. Cardiac troponin was significantly raised. Since the previous two weeks, he has been experiencing nephrotic syndrome symptoms including anasarca edema.It was supported by laboratory data which is obtained proteinuria, hyperlipidemia and hypoalbuminemia. A complete acute occlusion of the proximal portion of the left anterior descending artery was revealed by coronary angiography. Increased fibrinogen levels appeared to be a contributing factor for hypercoagulable state in this patient, implying a correlation between coronary thrombosis and nephrotic syndrome. Discussion: Myocardial infarction (MI) is rare in young males, but it occurs 8 times more often in patients with NS than in the general population. Clinicians should pay closer attention to the history of previous diseases with a high risk of thromboembolism in young patients with MI, and they should specifically promote thromboembolism prevention and care in patients with renal disease to decrease the incidence of thromboembolism complications. Conclusion: Nephrotic syndrome should be considered as a contributing factor in any patient presenting with acute STEMI, particularly in young males.
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Pancasari et al. (2021) conducted a case report in Acute ST elevation myocardial infarction (STEMI) and Nephrotic Syndrome (n=1). Nephrotic syndrome (hypercoagulable state) was evaluated on Acute STEMI (complete acute occlusion of the proximal LAD). A 24-year-old male with nephrotic syndrome developed an acute STEMI due to a complete acute occlusion of the proximal left anterior descending artery, likely driven by a hypercoagulable state.
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