Myocardial Infarction in patients with severe beta thalassaemia: A case series

Back Ground Cardiac disease remains a dominant if not the most important cause of morbidity and mortality in patients with thalassaemia, particular in those with thalassaemia major. Myocardial infarction and coronary artery disease however is rarely reported. Case Presentations Three older patients with three distinct thalassaemia syndromes presented with acute coronary syndrome. Two were heavily transfused whilst the other was a minimally transfused patient. Both heavily transfused patients had ST-elevation myocardial infarctions (STEMI) while the minimally transfused patient had unstable angina. Coronary angiogram (CA) was normal in two patients. One patient who developed a STEMI had a 50% plaque. All three were managed as standard ACS, although the aetiology appeared non-atherogenic. Conclusions: The exact etiology of the presentation, remains a mystery and therefore the rational use of thrombolytic, carrying out angiogram in the primary setting, using and continuing antiplatelet and high dose statins all remains unclear in this sub group of patients.