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The following electronic only articles are published in conjunction with this issue of Heart.
Protein C deficiency manifesting as an acute myocardial infarction and ischaemic stroke
I Y Tiong, M L Alkotob, S Ghaffari
Protein C deficiency is a disorder in the coagulation cascade that results in predominantly venous thromboembolism. However, recent studies have implicated this disorder as a possible contributor to arterial thrombosis, especially myocardial infarction. There are six reported cases of myocardial infarction secondary to protein C deficiency in the literature. This is the first report of myocardial infarction and ischaemic stroke in the same patient as a manifestation of protein C deficiency. The investigation of hypercoagulable state is an essential component of the investigation of young patients with myocardial infarction.
Obstructive intramural coronary amyloidosis and papillary muscle rupture
D Coisne, P Corbi, P Sosner
Mitral papillary muscle rupture is usually caused by ischaemia as a complication of myocardial infarction. In a 76 year old patient with no significant disease or major cardiovascular risk factors, papillary muscle rupture was caused by obstructive intramural coronary amyloidosis, an unusual cause.