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Coronary vasospasm, multiple coronary thrombosis, unstable angina and essential thrombocytosis

K K Koh1, S K Cho, S S Kim

  • 1Department of Internal Medicine, Inha University Hospital, Kyunggi-do, South Korea.

Insights

Essential thrombocythemia can rarely cause coronary artery occlusion. This case highlights coronary vasospasm and thrombosis in a patient with essential thrombocythemia, migraine, and Raynaud's phenomenon.

Area of Science:

  • Cardiology
  • Hematology
  • Vascular Medicine

Background:

  • Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by elevated platelet counts.
  • ET is associated with an increased risk of thrombotic and hemorrhagic complications.
  • Coronary artery occlusion is a rare but serious manifestation of ET.

Observation:

  • This report details a unique case of a woman experiencing coronary vasospasm and multiple coronary thromboses.
  • The patient presented with symptoms suggestive of myocardial infarction and unstable angina pectoris.
  • She had a medical history of migraine and Raynaud's phenomenon, in addition to essential thrombocytosis.

Findings:

  • Coronary angiography revealed extensive thrombosis involving both the right and left coronary arteries.
  • The findings suggest a potential link between ET, vasospastic disorders, and severe coronary events.
  • This presentation is distinct from previously reported cases of ET-associated coronary artery occlusion.

Implications:

  • This case underscores the importance of considering coronary artery thrombosis in patients with ET, especially those with concurrent vasospastic conditions.
  • Early recognition and management of thrombotic events in ET patients are crucial for preventing adverse cardiovascular outcomes.
  • Further research may elucidate the mechanisms underlying coronary thrombosis in ET and its association with vasospasm.

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