Introduction: Rifampicin is currently used to treat various bacterial infections, with the most significant application in the treatment of tuberculosis. Dose-independent side effects of the drug can lead to the development of various coagulation disorders, among which disseminated intravascular coagulation is the most dangerous. The mechanism of coagulopathy itself is multifactorial, but it is thought to be mediated by an immune response (formation of antigen-antibody complexes) and consequent damage to platelets and the vascular endothelium. Patient concerns: A 66-year-old woman, with numerous comorbidities including chronic renal failure, condition after implantation of a permanent pacemaker, and a positive blood culture for Staphylococcus aureus, presented with spontaneous bleeding in the muscle wall, and in the clinical picture of hemorrhagic shock. Diagnosis: Knowing the multifactorial mechanism of rifampicin-induced coagulopathy, possible factors were considered, such as infections, comorbidities, drug use and drug-drug interactions, pathological laboratory parameters, and coagulograms. Clinical presentation of abdominal pain and intra-abdominal mass, with laboratory verification of prolonged activated partial thromboplastin time and computed tomography-proven hematoma suspected of acute bleeding, redirects clinical suspicion of drug-induced coagulopathy. Interventions: By discontinuing rifapicin and administering vitamin K and fresh frozen plasma, normalization of laboratory coagulation parameters was achieved. Bleeding from the muscle wall required correction of acute anemia with red cell concentrates, surgical intervention, and additional antibiotic therapy for secondary infection of the operative wound. Outcomes: At the end of 6 weeks of antibiotic (antistaphylococcal) therapy (due to the basic suspicion of possible infectious endocarditis), the normalization of inflammatory parameters occurred with a sterile control blood culture and a normal coagulogram. Conclusion: Clinicians should be aware of the possible side effects of the administered drugs, especially taking into account the overall clinical picture of a patient, including comorbidities and possible drug interactions.

Background and Objectives: Younger and middle-aged women may continue to describe psychological and psychosocial burden years after myocardial infarction (MI), yet multicenter real-world data remain limited on what women retrospectively report during long-term follow-up. This study examined such reports in younger and middle-aged women with prior MI while explicitly accounting for delayed, heterogeneous follow-up timing and the non-standardized nature of symptom ascertainment. Materials and Methods: We performed a cross-sectional analysis within a Croatian multicenter cohort of 957 women younger than 60 years hospitalized with STEMI or NSTEMI between 1 February 2020 and 28 February 2025. Psychological information was collected retrospectively during routine follow-up; the formal PHQ-4 instrument was not administered. A study-specific four-item summary informed by PHQ-4 content was described, and exploratory multivariable analyses modelled this summary as a continuous variable. Descriptive timing-stratified sensitivity analyses and a timing-restricted continuous-score sensitivity model were additionally performed. Results: Prior psychiatric diagnosis was recorded in 16.0% of women, post-MI psychiatric diagnosis in 31.4%, and any psychosocial stressor in 73.2%. Among women with complete item responses, the four-item summary showed a broad distribution rather than a discrete threshold pattern. In continuous-score analyses, higher observed summary values were associated with younger age, prior psychiatric diagnosis, any psychosocial stressor, non-partnered status, non-employment, pregnancy complications/adverse pregnancy outcomes, and greater peri-menopausal symptom burden. Median summary values were only modestly higher in the small ≤ 1-year stratum and were otherwise similar across the later follow-up strata. Higher summary values were also associated with lower odds of self-reported regular current statin-based lipid-lowering use. Conclusions: These findings are best interpreted as exploratory data on retrospectively reported and currently endorsed long-term psychological and psychosocial burden years after MI, not as contemporaneous measures of recovery-phase psychopathology. Prospective studies with predefined assessment windows and validated instruments are needed.