fatemeh sehati
shaghayegh moosavi

Myocardial infarction leads to several complications. The prognosis in STEMI is largely related to the occurrence of two general classes of complications: (1) electrical complications (arrhythmias) and (2) mechanical complications (pump failure, myocardial rupture or valve malfunction). In addition, there are other direct and indirect complications affect on the prognosis in STEMI.Here we present a 50 -year-old man arrived to the emergency room with significant dyspnea and poor general condition. Two days before his arrival, his chest pain sensation and loss of consciousness causing him falling from a tree. His arrival lab tests consist of: Hb=9 g/dl, PLT=30000, Cr =1.8, INR=1.7, abnormal liver function test and positive troponin. According to his TEE(Trans-Esophageal-Echocardiography), EF(Ejection-Fraction) was 30-35% and there was akinesia in inferior and posterior cardiac wall with moderate right ventricle enlargement and dysfunction. In addition, flail of tricuspid valve with ruptured chordae and severe TR (Tricuspid regurgitation) was detected. Also, a 99% stenosis in proximal part of RCA (Right Coronary Artery) was noticed in his angiography result.Overall, this patient was the case of loss of consciousness probably due to arrhythmia following inferior STEMI. Severe TR occurred due to ruptured chordae following RV STEMI and falling from the tree. Additionally, thrombocytopenia occurred by acute valve malfunction and liver shock.

Myocardial infarction .Electrical and mechanical complications thrombocytopenia