THE MANAGEMENT OF ACUTE MYOCARDIAL-INFARCTION IN A PATIENT WITH POLYCYTHEMIA RUBRA VERA DURING THE THROMBOLYTIC ERA - DOES IT MAKE A DIFFERENCE

A 42-year-old man presented with acute anterior myocardial infarction and hemoglobin of 248 g/L. Laboratory studies sug- gested the diagnosi s of polycythemia rubra vera (PRV). Manage ment of this condition with acetylsalisylic acid, heparin, warfarin and phlebotomy constitutes a therapeutic dilemma. This case also brings up the question of the appr opriateness of thrombolysis and angioplasty in the treatment of myocar dial infarction in the presence of PRV. Due to the rarity of this hema tological disease, a call for international collaboration for assessin g the efficacy and safety of these treatment modalities is recommended .