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Myocardial infarction secondary to a coronary ostial thrombus in antiphospholipid syndrome

Ibrahim S Abu Romeh1, Adnan K Chhatriwalla, Fernando A Atik

  • 1The Cleveland Clinic, Cleveland, Ohio, USA.

The Annals of Thoracic Surgery
|February 20, 2007
PubMed

Insights

A rare case of antiphospholipid antibody syndrome presented as myocardial infarction and stroke. A cardiac mass, confirmed as a thrombus, was surgically removed, leading to diagnosis.

Area of Science:

  • Cardiology
  • Neurology
  • Rheumatology

Background:

  • Antiphospholipid antibody syndrome (APS) is a prothrombotic disorder.
  • Cardiac embolism is a known complication of APS.
  • Myocardial infarction and stroke can be presenting manifestations of APS.

Observation:

  • A 44-year-old woman experienced ST elevation myocardial infarction and right-hemisphere stroke.
  • Transesophageal echocardiography revealed a mass obstructing the right coronary artery origin.
  • Surgical excision and histological examination identified the mass as thrombotic.

Findings:

  • The patient was diagnosed with antiphospholipid antibody syndrome.
  • Positive lupus anticoagulant antibodies confirmed the APS diagnosis.
  • The cardiac thrombus was the source of embolism causing myocardial infarction and stroke.

Implications:

  • This case highlights the importance of considering APS in young patients with unexplained arterial thrombosis.
  • Early diagnosis and management of APS are crucial to prevent recurrent thromboembolic events.
  • Comprehensive cardiac evaluation is essential in patients with APS and neurological events.

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