P214 THE THERAPEUTIC IMPLICATIONS OF A FATAL COINCIDENCE

Abstract Background Factor VII deficiency is a rare, inherited disorder secondary to reduction or absence of factor (FVII) the coagulation pathway presenting with autosomal recessive transmission and caused by different types mutation F7 gene. The clinical manifestations syndrome are highly variable: depending on case, it can remain asymptomatic, present episodes bleeding trauma surgery, manifest potentially fatal spontaneous hemorrhages. It be treated long–term replacement prophylaxis, which consists periodic infusions FVII concentrates. Clinical case A 75–year–old woman presented emergency room in soporose state. On electrocardiogram, ST–segment elevation antero–septal AVR septal akinesia affecting left ventricle was shown. admission, she syncope, marked hypotension, tonic–clonic spasm. Blood tests showed sodium levels 112 mEq/L, administration high doses Escitalopram associated genesis epileptic seizures. During coronary angiography, severe stenosis mid–proximal IVA seenand subsequently PTCA/DES. Right before procedure, therapy Acetylsalicylic acid (ASA) 250 mg, Ticagrelor 180 Heparin administered 5000 IU + IU. Immediately after, anemia (5.9 Hb) INR lengthening were demonstrated, widespread skin hematomas. In complete study coagulative state, an almost found, required infusion concentrate. subsequent course further complicated pre–renal acute renal failure paroxysmal atrial fibrillation. Following initial suspension antiplatelet anticoagulant (OAT), possible reintroduce, without loading dose, ASA clopidogrel, preserving OAT for later phases. Discussion Conclusions deficiency, rare hemorrhagic disorder, may represent coincidence context myocardial infarction, due therapeutic implications pathology, lead inevitable uncontrolled bleeding. This occurrence difficult predict some cases, including one. would interesting identify indicators that could prompt, even setting, suspicion such dangerous association.