Acute Myocardial Infarction as an Initial Presentation of Protein C and Protein S Deficiency Followed by Dilated Cardiomyopathy in a Young Male

Abstract

Protein C and protein S are vitamin K dependent anti-coagulant proteins required for the inhibition of activated protein V and VIII. In an inherited thrombophilia, hypercoagulability caused by the deficiency of protein C and protein S predisposes an individual to increased risk of thromboembolism (TE) that could herald as a venous thromboemboilsm (VTE) in the leg, pulmonary embolism (PE), stroke, or Budd-Chiari syndrome. However, very rarely does inherited thrombophilia cause coronary artery thrombosis leading to the development of myocardial infarction (MI). We report a case of a young male with combined protein C and protein S deficiency who presented with acute MI, worsened ventricular systolic function, and progressive declination of ejection fraction (EF) secondary to dilated cardiomyopathy (DCM).

A Rare Case of Myocardial Infarction with Nonobstructive Coronary Arteries Due to Hereditary Thrombophilia

“…Protein C and protein S deficiency have been reported in disorders like nephritic syndrome, inflammatory bowel disease, human immunodeficiency virus, varicella, multiple myeloma, sepsis, etc. 9 Although they more commonly manifest as venous thromboembolism, rarely they can present as arterial thrombosis in the ratio of 24:1with fatal mortality.…”

Levels of Protein S in Saudi Patients with Myocardial Infarction

“…Cardiovascular disease (CVD) is still the major cause of death and morbidity worldwide, and its prevalence is rising. Myocardial infarction (MI) is the most frequent kind of CVD is caused by an atherosclerotic plaque and mainly affects adults [1]. When blood flow to a section of the heart is cut off, damage to the heart muscle occurs.…”