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Acute myocardial infarction: an unusual culmination of rheumatic pancarditis and antiphospholipid antibody syndrome
Author(s) -
Izhevsky D.,
Maple J. T.,
Ommen S. R.
Publication year - 2004
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.0954-6820.2003.01254.x
Subject(s) - medicine , thrombosis , myocardial infarction , cardiology , antiphospholipid syndrome , coronary thrombosis , acute coronary syndrome , pathogenesis , acute rheumatic fever , rheumatic fever
. A 29‐year‐old man with history of antiphospholipid antibody syndrome (APS) and two prior episodes of acute rheumatic fever developed a third episode of acute rheumatic fever. This was complicated by acute myocardial infarction due to spontaneous arterial thrombosis of the left anterior descending and right coronary arteries. We postulate that rheumatic pancarditis created an inflammatory, thrombogenic environment that facilitated coronary artery thrombosis secondary to APS, a novel association. Our patient was left with significant left ventricular dysfunction at a young age, and cases such as this emphasize the need for early recognition and proper treatment of APS. Further, the pathogenesis of thrombosis in APS is incompletely understood, and the cellular and molecular basis for this, including the role of ‘second hits’, are areas needing further investigation.