[Acute myocardial infarction and chronic leukaemia with significant thrombocytopenia]. / Pacjent z zawalem serca i przewlekla bialaczka limfocytowa. Trudnosci w leczeniu ostrego zespolu wiencowego u chorych z istotna klinicznie trombocytopenia.

We present a case of a 62 year-old male with acute myocardial infarction, chronic leukaemia and significant thrombocytopenia (50 g/L). The patient underwent primary coronary intervention followed by full antiplatelet and antithrombotic treatment without bleeding complications.

Myocardial infarction in a low risk patient with hereditary hemorrhagic telangiectasia.

We describe the case of a 57 year-old woman with NSTE ACS, a history of recurrent and prolonged epistaxis, and low prior cardiovascular risk. Additional findings revealed anemia and an aneurysm in her central nervous system. During her hospital stay, hereditary hemorrhagic telangiectasia (HHT) was diagnosed. After application of two antiplatelet drugs, the patient was scheduled for coronarography, followed by coronary artery bypass grafting. During her hospital stay, only a minor episode of epistaxis was observed. We conclude that anemization due to HTT may significantly accelerate the progress of ischemic heart disease, resulting in acute coronary syndrome. Moreover, coronarography preceded by routine application of two antiplatelet drugs seems not to increase the risk of hemorrhage in HHT patients complicated with myocardial infarction.

Compliance with Low Molecular Weight Heparin in abulatory orthopedic patients.

Background The prophylaxis of venous thromboembolism with unfractioned heparins (UFH) was introduced in 1970s and initially applied only in high-risk orthopedic surgery patients. While further studies proved its importance also in those with lower risk, it was the development of LMWH, that enabled wide practical application. The primary objective of this study was to provide a complex evaluation of actual compliance with self-administered Low Molecular Weight Heparin in ambulatory orthopedic patients. Assessment of incidence of LMWH side-effects and thromboembolic episodes despite proper prophylaxis were defined as secondary objectives. Material and methods The research was conducted in Brodnowski Hospital, Warsaw and WSzZ Hospital, Kielce. The group consisted of n=120 (58 females, age 17-82) patients. The selection criteria were: having plaster immobilization definitely removed and being prescribed LMWH as a part of the treatment. Participants were given anonymous questionnaires composed of 25 questions. Satisfactory compliance was defined as application of at least 80% of prescribed injections. Results Compliance with LMWH appeared to be satisfactory in 95.8% cases of which 63,6% were fully and 32,2% partially compliant. The most frequent reasons for dose omission were forgetfulness (48.9%), fear of side-effects (20.0%) and side-effects (13.3%). Side effects were observed in 26.7% of drug applying patients and due to this fact 16.4% temporarily stopped injections. Venous thromboembolism was reported in 6.0%. Conclusions Compliance level in great majority proved to be satisfactory, although the necessity of prophylaxis was far from being fully recognized by the patients. It also seemed unaffected by the significant number of side effects. Thromboembolic episodes were sporadically reported.