Acute ST-segment elevation myocardial infarction secondary to vaccine-induced immune thrombosis with thrombocytopaenia (VITT).
BMJ Case Rep
; 14(9)2021 Sep 27.
Article
in English
| MEDLINE | ID: covidwho-1440813
ABSTRACT
A 40-year-old man with no cardiac history presented with central chest pain 8 days after receiving the ChAdOx1 nCov-19 vaccine against COVID-19. Initial blood tests demonstrated a thrombocytopaenia (24×109 µg/L) and a raised d-dimer (>110 000 µg/L), and he was urgently transferred to our tertiary referral central for suspected vaccine-induced immune thrombocytopaenia and thrombosis (VITT). He developed dynamic ischaemic electrocardiographic changes with ST elevation, a troponin of 3185 ng/L, and regional wall motion abnormalities. An occlusion of his left anterior descending coronary artery was seen on CT coronary angiography. His platelet factor-4 (PF-4) antibody returned strongly positive. He was urgently treated for presumed VITT with intravenous immunoglobulin, methylprednisolone and plasma exchange, but remained thrombocytopaenic and was initiated on rituximab. Argatroban was used for anticoagulation for his myocardial infarction while he remained thrombocytopaenic. After 6 days, his platelet count improved, and his PF-4 antibody level, troponin and d-dimer fell. He was successfully discharged after 14 days.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Thrombocytopenia
/
Thrombosis
/
Vaccines
/
Purpura, Thrombocytopenic, Idiopathic
/
ST Elevation Myocardial Infarction
/
COVID-19
/
Myocardial Infarction
Type of study:
Case report
/
Prognostic study
Topics:
Vaccines
Limits:
Adult
/
Humans
/
Male
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Bcr-2021-245218
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