A.N. MAKSUDOVA¹, T.N. KHALFINA¹, G.I. NURULLINA¹, O.YU. FAKHRUTDINOVA², G.M. ISLAMOVA², A.F. KHIDIYATOVA¹, S.M. LEVINA¹, YU.A. KOKORINA¹    

²Republic Clinical Hospital of the MH of RT, Kazan

Contact details:

Nurullina G.I. — PhD (medicine), Associate Professor of the Department of Hospital Therapy

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7 (843) 290-18-20, e-mail: nurguzel@yandex.ru

Thromboembolic complications in nephrotic syndrome (NS) are frequently encountered in the practice of a nephrologist and in many cases determine the course and outcome of diseases. The article presents a clinical case of acute ST-segment elevation myocardial infarction with Q tooth of posterior basal, lateral localization in a 36-year-old patient with a newly diagnosed nephrotic syndrome. In the young patient without a history of cardiovascular risk factors, coronary angiography revealed signs of progressive atherosclerotic stenosis of the coronary arteries, and the cause of MI was thrombotic occlusion of the enveloping branch of the left coronary artery. This clinical case required a more detailed study; the examination revealed a set of factors that led to MI in this young patient.

Key words: myocardial infarction with a ST-segment elevation, young age, nephrotic syndrome, dyslipidemia, thromboembolic complications.

REFERENCES

1. Rabelink T.J., Zwaginga J.J., Koomans H.A. et al. Thrombosis and hemostasis in renal disease. Kidney Int, 1994, vol. 46, pp. 287–296.
2. Zaffanello M., Franchini M. Thromboembolism in childhood nephrotic syndrome: a rare but serious complication. Hematology, 2007, vol. 12, pp. 69–73.
3. Ikeda S., Takaya Y., Takahashi K. et al. A case of nephrotic syndrome associated with pulmonary infarction and renal vein thrombosis (a review of literature). Nihon Jinzo Gakkai Shi, 1989, Aug, vol. 31 (8), pp. 883–889.
4. Lee C.H., Chen K.S., Tsai F.C. et al. (2000). Concurrent thrombosis of cerebral and femoral arteries in a patient with nephrotic syndrome. American journal of nephrology, 2000, vol. 20 (6), pp. 483–486. DOI: 10.1159/000046204
5. Vestergaard S.V., Birn H., Darvalics B. et al. Risk of Arterial Thromboembolism, Venous Thromboembolism, and Bleeding in Patients with Nephrotic Syndrome: A Population-Based Cohort Study. Am J Med, 2022, May, vol. 135 (5), pp. 615–625. DOI: 10.1016/j.amjmed.2021.11.018 Epub 2021 Dec 31. PMID: 34979093.
6. Khan J.A., Masood T., Shamsi F. Nephrotic syndrome: a rare cause of acute coronary syndrome in a child. J Coll Physicians Surg Pak, 2012, vol. 22, pp. 123–125.
7. Zhao Y., Su W., Liu S. et al. Acute myocardial infarction in a young girl with nephrotic syndrome: a case report and literature. Can J Cardiol., 2017, vol. 33, p. 950.
8. Sjuls S., Jensen U., Littmann K. et al. Effective cholesterol lowering after myocardial infarction in patients with nephrotic syndrome may require a multi-pharmacological approach: a case report. Eur Heart J Case Rep, 2021, May 13, vol. 5 (5), p. 151. DOI: 10.1093/ehjcr/ytab151 PMID: 34124564; PMCID: PMC8189300.