Acute myocardial infarction following transfusion reaction

Gopalakrishnan PP, Tak T 
Correspondence: Dr Tahir Tak, tak.tahir@mayo.edu

ABSTRACT
Indications for blood transfusion in critically-ill patients in general have become very restrictive. Still, the role for blood transfusion in the setting of acute coronary syndrome is unclear, as evidence regarding outcomes with different blood transfusion strategies has been conflicting. We report a 53-year-old Hispanic woman with acute ST-elevation myocardial infarction (STEMI) following a febrile nonhaemolytic transfusion reaction. Coronary angiogram showed complete occlusion of intracoronary stent in the left anterior descending (LAD) artery. Angiogram done earlier in the day had shown complete patency of the LAD stent with good distal flow. This suggests a possible role for the febrile nonhaemolytic transfusion reaction in triggering the stent occlusion and development of the STEMI.

Keywords: acute coronary syndrome, anaemia, blood transfusion, myocardial infarction, ST elevation myocardial infarction, transfusion reaction
Singapore Med J 2008; 49(4): e101-e103