Myocardial infarction in a 33-year-old with inflammatory bowel disease: a case report

• Published in: BMC cardiovascular disorders Vol. 23; no. 1; pp. 253 - 8
• Main Authors: Bengel, Christopher Paul, Müller-Gastell, Denisa, Al-Najjar, Bassam, Cherednichenko, Irina, Kacapor, Rifat
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.05.2023; BioMed Central; BMC
• Subjects: Acids; Adult; Antibodies; Anticoagulants; Arteriosclerosis; Blood clots; Cardiovascular diseases; Case Report; Case reports; Case studies; Coronary Angiography; Coronary artery; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary vessels; Embolisms; Heart attack; Heart attacks; Hemoglobin; Humans; Inflammation; Inflammatory Bowel Disease; Inflammatory Bowel Diseases; Intestine; Ischemia; Laboratories; Magnetic resonance imaging; Medical imaging; MINOCA; Myocardial Infarction; Myocardial Infarction - diagnosis; Myocardial Infarction - etiology; Myocardial Infarction - therapy; Myocardial Ischemia; STEMI; Thromboembolism; Thrombosis; Veins & arteries; Germany; STEMI; Case report; Myocardial Infarction; Inflammation; Inflammatory Bowel Disease; MINOCA
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-023-03284-x

ST elevation myocardial infarction is defined as acute myocardial injury with necrosis due to myocardial ischemia. The frequent cause is thrombotic occlusion of atherosclerotic coronary arteries. In particular situations, thromboembolism can cause myocardial infarction in patients with normal coronary arteries. We report a particular case of myocardial infarction in a young, previously healthy patient with non-atherosclerotic coronary arteries and inflammatory bowel disease. Although we performed an extensive work up, no clear pathophysiological cause could be diagnosed. Most likely, myocardial infarction was associated with a hypercoagulative state related to systemic inflammation. The mechanisms of coagulation disturbances in the context of acute and chronic inflammation are not yet fully understood. A better understanding of cardiovascular events in patients with inflammatory bowel disease might lead to new treatment approaches of cardiovascular disease.