iarjmcrIARJMCRIARJMCR2709-3220https://doi.org/10.47310/iarjmcr.2023.v04i02.002Factor V leiden deficiency as cause of left main thrombosisKhaleelMusallamHassanQaderiMoathMarashdehAliAlrousanHamzehMrayatAcute coronary syndrome is rarely presented in a young healthy male with no precious cardiac risk factor, factor V leiden mutation is known cause of venous thrombosis and rarely arterial. In this case we present a young male who presented with STEMi and was later found to have factor V leiden mutation as the underlying cause. Later, we discuss the management approach in such patients with tirofiban and lack of need off stent placement.