[Severe anemia-induced type 2 myocardial infarction].

Acute bleeding can cause severe anemia-induced type 2 myocardial infarction in those with significant prior atherosclerotic coronary disease, but not plaque rupture. The authors present four cases where coronarography is presented together with the alarming ECG abnormalities. With their cases, they draw attention that suspected anemia in combination with extensive ST depression may cause type 2 myocardial infarction. In such cases, it is recommended to wait with the otherwise justified double antiplatelet or heparin treatment. In the case of severe anemia (hemoglobin <80 g/L) and extensive ST-depression, there is almost always a small increase in the high sensitivity troponin T and creatine kinase levels. Early transfusion with the appropriate management of bleeding source usually precedes coronary intervention. In three of their cases, even the most serious ischemic ECG abnormalities disappeared or regressed as a result of the transfusion. As far as they know, the authors present pathological Q-waves disappearing for blood transfusion first. Orv Hetil. 2026; 167(5): 188-195.