Primary antiphospholipid syndrome with acute myocardial infarction recanalised by PTCA

• Published in: Heart (British Cardiac Society) Vol. 79; no. 1; pp. 96 - 98
• Main Authors: Takeuchi, Susumu, Obayashi, Toshihiro, Toyama, Junji
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.01.1998; BMJ; BMJ Publishing Group LTD
• Subjects: acute myocardial infarction; Adult; Angioplasty; Angioplasty, Balloon, Coronary; Anticoagulants; Antiphospholipid Syndrome - complications; Antiphospholipid Syndrome - diagnosis; Antiphospholipid Syndrome - diagnostic imaging; Biological and medical sciences; Cardiology. Vascular system; Case Report; Coronary Angiography; Coronary heart disease; Heart; Heart attacks; Humans; Lupus; Male; Medical sciences; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - etiology; Myocardial Infarction - therapy; percutaneous transluminal coronary angioplasty; primary antiphospholipid syndrome; Veins & arteries; Human; Immunopathology; Antiphospholipid antibody syndrome; Infarct; Acute; Treatment efficiency; Coronary artery; Instrumentation therapy; Cardiovascular disease; Autoimmune disease; Hemopathy; Anticoagulant; Instrumental dilatation; Coronary heart disease; Myocardial disease; Vascular disease; Case study; Chemotherapy; Platelet; Treatment; Primary; Myocardium
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.79.1.96

A 20 year old man with severe chest pain was hospitalised for acute myocardial infarction. Coronary angiography revealed total obstruction of his right coronary artery, which was successfully recanalised by direct percutaneous transluminal coronary angioplasty (PTCA). There was also diffuse thrombi in the left coronary artery that was not recanalised by perfusion with 3000 U pro-urokinase. Anticoagulant therapy was performed after PTCA. Creatine kinase peaked one day after hospitalisation (4805 U/l). The activated partial thromboplastin time was 62.6 seconds (45%). Plasma anticardiolipin IgG antibodies were high (3.8 and 2.7) in repeated examinations. The PTCA site was patent after three months. Primary antiphospholipid syndrome should be considered as a cause of acute myocardial infarction in young adults, and PTCA with anticoagulant treatment is effective for initial treatment of the syndrome.