Myocardial ischaemia with a normal coronary angiogram due to the primary antiphospholipid syndrome

In this case report, we describe a 33-year-old woman with a history of two unprovoked thrombo-embolic events presenting with acute myocardial ischaemia. She had a normal coronary angiogram (CAG). The diagnosis primary antiphospholipid syndrome (APS), an acquired hypercoagulability disorder, was established by the presence of antibodies directed against phospholipids. The primary APS should be considered as a cause of myocardial ischaemia in patients with a normal CAG and a history of unprovoked thrombo-embolic events.