Myocardial infarction following recombinant activated factor VII in a patient with type 2A von Willebrand disease.

We describe a 50-year-old man with von Willebrand disease type 2A who suffers from angiodysplasia and has required many transfusions for gastro-intestinal haemorrhage. Various investigative modalities have not demonstrated a single source for this. Following a case report of successful use of recombinant activated factor VII (NovoSeven; Novo Nordisk, Copenhagen, Denmark), the patient was treated with it but suffered a large myocardial infarct. As the patient has risk factors for atherosclerotic disease, we presume the recombinant activated factor VII promoted coagulation at a pre-existing atherosclerotic lesion.