Myocardial infarction and primary thrombocytosis in a young man

We report the case of a 27-year-old male smoker with simultaneous myocardial infarction (MI) and acute peripheral ischaemia. At the time of his first hospitalization, the platelet count and the coronary angiogram were normal. Two years later, the patient presented again with a leg artery occlusion, followed, a few days later, by a recurrence of MI. At this time, the platelet count was high and the coronary angiogram revealed an occlusion of the right coronary artery. The diagnosis of primary thrombocytosis was made by bone marrow aspiration and biopsy. Different unusual mechanisms of MI in young people are discussed in this report.