Publications

Abstract

This case presents a young patient with myocardial infarction, in-situ thrombosis of left anterior descending coronary artery and right common-iliac artery due to primary antiphospholipid syndrome. This report discusses the relationship between antiphospholipid antibodies and coronary artery disease along with management of this rare condition.

Introduction

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis, and recurrent fetal loss, often accompanied by a thrombocytopenia, and elevated titers of antiphospholipid antibodies (aPL), namely, the lupus anticoagulant (LA) and/or anticardiolipin antibodies (aCL). The syndrome occurs in isolation (Primary Antiphospholipid Syndrome) or in association with connective tissue diseases (Secondary Antiphospholipid Syndrome), particularly systemic lupus erythematosus.1 Cardiac manifestations in APS may include myocardial infarction (MI), valve thickening/dysfunction, angina, cardiomyopathy, vegetations, coronary bypass graft thrombosis, intracardiac thrombus and pulmonary embolism/hypertension.2 MI can be the first manifestation of APS, although it is not common.

This case present a young patient with MI, in-situ thrombosis of the left anterior descending coronary artery and right common-iliac artery due to primary APS.

In conclusion, young patients presenting with vascular thrombosis in two different territories, as well as those presenting with myocardial infarction and normal coronaries with or without intracoronary thrombus should be investigated for APS and managed with long-term anticoagulation