A rare complication of blood donation: MINOCA

Am J Emerg Med. 2024 Dec 7:S0735-6757(24)00686-7. doi: 10.1016/j.ajem.2024.12.003. Online ahead of print.

Abstract

Blood donation is a life-saving process that involves the temporary loss of a specific blood volume. Although generally safe, it may lead to adverse reactions, particularly in first-time donors. Among these, severe outcomes like myocardial infarction (MI) are extremely rare. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a distinct clinical entity with various potential etiologies, including coronary vasospasm and sudden hemodynamic changes. This report aims to present a rare case of MINOCA following blood donation to highlight the importance of comprehensive evaluation in blood donors presenting with acute symptoms. A 39-year-old male presented to the emergency department with dizziness and blurred vision following blood donation. Initial assessment revealed normal vital signs, laboratory tests, and no prior medical history. Electrocardiography showed ST-segment elevation in leads D1 and AVL, and ST-segment depression in D3 and AVF. The patient was immediately treated with acetylsalicylic acid and underwent coronary angiography, which revealed normal coronary arteries. The pathological findings on the ECG resolved after the procedure. No changes in troponin levels were observed during intensive care follow-up, and the patient was discharged in good health after two days. MINOCA requires thorough investigation to determine underlying causes. Acute volume loss and sudden intravascular hemoglobin changes were likely contributing factors in this case. Although rare, the association between blood donation and MINOCA highlights the need for vigilance in donors with acute symptoms. Blood donors presenting with dizziness or hypotension should be evaluated comprehensively.

Keywords: Acute coronary syndrome; Blood donation; Blood transfusion; Emergency room.

Publication types

  • Case Reports