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Acute myocardial ischemia in a patient with heterozygous alpha-2-plasmin inhibitor deficiency.

In this brief report we present a patient with heterozygous alpha2 plasmin inhibitor (alpha2PI) deficiency who developed atherosclerosis and myocardial ischemia in the presence of multiple classical risk factors. Management was complicated by fear of bleeding complications with the use of antiplatelet agents and serious comorbidity.The role of alpha2PI in atherosclerosis and pathological clot formation is still not clear. This case shows, however, that atherosclerosis and acute cardiovascular events can develop in patients with reduced alpha2PI levels.