Abstract
Introduction: Plasma donation is generally considered a safe procedure, and most reported adverse events are related to venipuncture or transient volume loss. Arterial thrombotic events, including acute myocardial infarction, are exceedingly rare but have been described after source plasma donation performed by plasmapheresis. We report a young man without traditional cardiovascular risk factors who presented with acute ST-elevation myocardial infarction after plasma donation.
Case presentation: A 27-year-old man with eczema and intermittent cannabis use presented with chest pain approximately 12 hours after plasma donation. Electrocardiography demonstrated anterolateral ST-segment elevation, and coronary angiography showed a large proximal left anterior descending (LAD) artery thrombus with TIMI 1 flow. Aspiration thrombectomy restored TIMI 3 flow, although residual stenosis persisted. A repeat angiogram performed two days later showed persistent proximal LAD thrombus. When the patient returned several days later for completion of the evaluation, repeat angiography demonstrated a contained proximal LAD dissection without residual thrombus; based on the initial angiographic appearance and interval development after thrombectomy, this finding was considered most consistent with a procedural complication rather than the primary cause of presentation. Transthoracic echocardiography showed new severe left ventricular systolic dysfunction with an ejection fraction of 20%–25% and extensive apical akinesis.
Conclusion: Plasma donation may rarely be followed by arterial thrombosis, including ST-elevation myocardial infarction. In this case, plasma donation was considered a plausible trigger for coronary thrombosis, while cannabis use represented a potential additional contributing factor. Persistent ischemic symptoms after donation warrant prompt evaluation for acute coronary syndrome.
Keywords
Cardiovascular Therapeutics, Coronary artery disease, Coronary thrombosis, STEMI