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Myocardial infarction, persistent coronary artery thrombosis and lupus anticoagulant

T J Mills1, R E Safford, F J Kazmier

  • 1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota.

International Journal of Cardiology
|November 1, 1988
PubMed

Insights

A lupus anticoagulant, a blood clotting disorder, was linked to recurrent heart attacks in a 40-year-old man. Testing for this condition is crucial in patients experiencing multiple thrombotic events.

Area of Science:

  • Cardiology
  • Hematology
  • Immunology

Background:

  • Recurrent myocardial infarctions (heart attacks) can indicate underlying thrombotic disorders.
  • Exertional angina may be a symptom of significant coronary artery disease or thrombosis.
  • Intramural thrombus formation requires investigation beyond typical atherosclerosis.

Observation:

  • A 40-year-old male presented with exertional angina and a history of two myocardial infarctions in the same coronary distribution.
  • Coronary arteriography identified a large intramural thrombus in the right coronary artery with minimal atherosclerotic disease.
  • Special coagulation studies revealed a circulating lupus anticoagulant.

Findings:

  • The presence of a lupus anticoagulant was associated with repeated thrombotic events in the coronary arteries.
  • This case highlights a rare cause of recurrent myocardial infarction in a relatively young patient.
  • Minimal atherosclerosis suggests thrombosis is the primary driver of myocardial infarction.

Implications:

  • Lupus anticoagulant testing should be considered in patients with recurrent thrombotic events, especially younger individuals.
  • Early diagnosis of lupus anticoagulant can guide anticoagulation therapy and prevent future cardiovascular events.
  • Understanding the link between autoimmune disorders and thrombosis is vital for comprehensive patient care.

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