Primary Antiphospholipid Antibody Syndrome Presenting as Acute Myocardial Infarction

Area of Science:

• Cardiology
• Pathology

Background:

• Acute myocardial infarction (AMI) is a common cardiovascular emergency.
• Cardiac tumors are rare and can present with diverse symptoms, sometimes mimicking other cardiac conditions.

Observation:

• A 46-year-old woman presented with sudden chest discomfort and diaphoresis, initially suspected as AMI.
• Coronary angiography revealed left anterior descending artery occlusion, with aspiration yielding friable tissue.

Findings:

• Histopathology confirmed a fibrin-rich thrombus, suggesting a cardiac mass rather than typical atherosclerosis.
• The patient was treated with anticoagulation (enoxaparin, warfarin), leading to a significant reduction in a mitral valve nodular mass.

Implications:

• This case underscores the importance of considering cardiac tumors in the differential diagnosis of acute coronary syndromes.
• Effective management involves accurate histopathological diagnosis and appropriate anticoagulation therapy.
• Long-term anticoagulation may be necessary for patients with cardiac tumors presenting as thrombi.