Related Experiment Video
Updated: Aug 6, 2026

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Transient Coronary Thrombosis Mimicking Myopericarditis Revealing JAK2-Positive Essential Thrombocythemia
Paisit Kosum1, Akenarong Pipatputthapong1, Pongpun Jittham1
1Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand; Cardiac Center, Naresuan University Hospital, Phitsanulok, Thailand.
Background:
Acute coronary thrombosis without atherosclerosis may mimic myopericarditis, particularly in young patients.
Case Summary:
A 20-year-old woman presented with pleuritic chest pain following a viral illness. Serial electrocardiography showed dynamic ST-segment elevation in leads V3 to V6, and high-sensitivity troponin T increased from 18.6 to 1,151 ng/L. Echocardiography demonstrated regional wall motion abnormalities in the left anterior descending territory. Coronary angiography revealed a proximal left anterior descending intraluminal thrombus causing severe narrowing without underlying atherosclerosis. Conservative management with anticoagulation and dual antiplatelet therapy was initiated. Repeat angiography after 3 days showed complete thrombus resolution with no residual stenosis. Further evaluation revealed marked thrombocytosis and a JAK2 V617F mutation, confirming essential thrombocythemia.
Discussion:
This case highlights a mechanism-based approach to myopericarditis-like presentations. JAK2-positive essential thrombocythemia represents a plausible prothrombotic contributor after the exclusion of common causes of coronary artery disease in very young patients.
Take-Home Message:
Dynamic regional electrocardiogram changes, rapid troponin elevation, and regional wall motion abnormalities should prompt coronary evaluation despite pleuritic symptoms.
Related Concept Videos
Myocarditis II: Clinical Features and Diagnostic Tests
Pericarditis II: Clinical Features and Diagnostic Tests
Myocarditis I: Introduction
Pericarditis I: Introduction
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Acute Coronary Syndrome III: Diagnostic Studies
