Satiroğlu Omer, Vural Mutlu, Uyar Ibrahim, Bostan Mehmet
Department of Cardiology, Medicine Faculty of Rize University, Rize, Turkey.
Turk Kardiyol Dern Ars. 2010 Apr;38(3):194-7.
There are several reports on the association between the factor V Leiden mutation and acute myocardial infarction (AMI) in young patients, in particular young males. A 28-year-old male patient was admitted with severe chest pain of new onset. He was an active smoker. His father had a history of coronary artery disease and AMI after the age of 45 years. There were no other major coronary risk factors. His electrocardiogram showed ST-segment elevation in the precordial leads V1 to V5. His blood pressure, pulse rate, and other clinical parameters were stable. Emergency coronary angiography showed a significant narrowing in the mid-portion of the left anterior descending (LAD) artery with a moderate intracoronary thrombus, and no or minimal atherosclerosis. The other coronary arteries were normal. Direct stenting was performed for the culprit lesion, which resulted in relief of obstruction and significant improvement in the LAD artery. DNA samples isolated from the peripheral blood were analyzed by polymerase chain reaction and the patient was found to be homozygous for the factor V Leiden mutation. Transthoracic echocardiography before discharge showed only mild hypokinesis of the anterior and apical segments.
有几篇关于年轻患者，尤其是年轻男性中因子V莱顿突变与急性心肌梗死（AMI）之间关联的报道。一名28岁男性患者因新发严重胸痛入院。他是一名活跃吸烟者。他的父亲有冠状动脉疾病史，45岁后发生过AMI。没有其他主要的冠状动脉危险因素。他的心电图显示胸前导联V1至V5 ST段抬高。他的血压、脉搏率和其他临床参数稳定。急诊冠状动脉造影显示左前降支（LAD）动脉中段明显狭窄，伴有中度冠状动脉内血栓形成，且无或仅有轻微动脉粥样硬化。其他冠状动脉正常。对罪犯病变进行了直接支架置入术，这使得阻塞得到缓解，LAD动脉有显著改善。通过聚合酶链反应分析从外周血中分离的DNA样本，发现该患者因子V莱顿突变为纯合子。出院前经胸超声心动图仅显示前壁和心尖段轻度运动减弱。
