# Case report of severe coronary artery disease complicated by malignant arrhythmia due to inherited thrombophilia

## TL;DR

A young man with inherited thrombophilia suffered severe heart disease and arrhythmia, highlighting the need for early screening in young patients with coronary issues.

## Contribution

This case emphasizes the importance of screening young patients with coronary artery disease for inherited thrombophilia.

## Key findings

- The patient had two thrombophilia alleles (PAI-1 4G/5G and MTHFR C > T) linked to arterial thrombosis.
- Thrombophilia led to severe coronary occlusion, myocardial scarring, and ventricular tachycardia.
- Early screening for thrombophilia could improve outcomes in young patients with coronary artery disease.

## Abstract

The principal clinical manifestation of thrombophilia is venous thromboembolism, which is also markedly linked to arterial thrombosis, including myocardial infarction. Nevertheless, patients presenting with an early-onset myocardial infarction are seldom screened for thrombophilic genes, resulting in delayed diagnosis and an unfavourable prognosis. This report presents the case of a young man who suffered an acute myocardial infarction as a result of thrombophilia. The patient had a history of deep vein thrombosis and was genetically tested to carry two thrombophilia susceptibility alleles at the PAI-1 (4G/5G) and MTHFR (C > T) loci. This ultimately resulted in severe coronary artery occlusion, myocardial scarring and frequent episodes of ventricular tachycardia, which had a significant impact on the patient's quality of life. The objective of this report was to enhance clinicians' awareness of embolism susceptibility. It is recommended that young and middle-aged patients with severe coronary artery stenosis undergo screening for embolism.