Oancea Andra, Maștaleru Alexandra, Abdulan Irina Mihaela, Costache Alexandru Dan, Zota Mădălina Ioana, Negru Robert, Moisă Ștefana, Trandafir Laura Mihaela, Leon Maria Magdalena
Department of Medical Specialties I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Clinical Rehabilitation Hospital, 700661 Iasi, Romania.
Reports (MDPI). 2023 Aug 22;6(3):39. doi: 10.3390/reports6030039.
FV Leiden is an autosomal dominant disease, representing one of the most prevalent genetic causes for hereditary thrombophilia manifested by venous thromboembolism.
We report a case of a 30-year-old patient who was admitted for enrollment in phase II cardiac rehabilitation. The cardiovascular disease onset was five years ago when the patient was diagnosed with superficial vein thrombosis, for which anticoagulant treatment was recommended. However, he discontinued the prescribed treatment independently, which resulted in the development of deep vein thrombosis. A screening for risk factors associated with venous thromboembolism was conducted, leading to the identification of a heterozygous mutation of factor V Leiden. Later, the patient was hospitalized for acute coronary syndrome necessitating stent implantation. Following this procedure, the patient started a cardiac rehabilitation program, where the patient received multidisciplinary counseling.
At the end of the cardiac rehab, significant improvements were observed in clinical and hemodynamic parameters. Consequently, the patient was advised to continue rehabilitation treatment in the outpatient setting. Also, for patients with suboptimal maintenance of the therapeutic range of INR, the use of apixaban might be considered. Furthermore, the utilization of a reduced dosage of apixaban has demonstrated its effectiveness in preventing further venous thromboembolism.
因子V莱顿突变是一种常染色体显性疾病，是遗传性血栓形成倾向最常见的遗传原因之一，表现为静脉血栓栓塞。
我们报告一例30岁患者，因参加II期心脏康复计划入院。该患者5年前被诊断为浅静脉血栓形成，当时心血管疾病发作，建议进行抗凝治疗。然而，他自行中断了规定的治疗，导致深静脉血栓形成。对与静脉血栓栓塞相关的危险因素进行了筛查，结果发现因子V莱顿杂合突变。后来，该患者因急性冠状动脉综合征住院，需要进行支架植入。在此手术后，患者开始了心脏康复计划，并接受了多学科咨询。
在心脏康复结束时，观察到临床和血流动力学参数有显著改善。因此，建议患者在门诊继续康复治疗。此外，对于国际标准化比值（INR）治疗范围维持不佳的患者，可考虑使用阿哌沙班。此外，使用较低剂量的阿哌沙班已证明其在预防进一步静脉血栓栓塞方面的有效性。
