Acute myocardial infarction and antiphospholipid syndrome – clinical case and review

Abstract

Acute myocardial infarction (AMI) is myocardial cell death due to prolonged ischemia.Alongside the most common type of AMI – first type, caused by rupture or erosion of an atheroscleroticplaque, other causes such as coronary spasm, embolism, arterial dissection, sustained arrhythmia,anemia, severe respiratory failure should not be forgotten. We present a clinical case of a 40-year-oldfemale with acute inferior myocardial infarction with persistent ST-elevation. Because of the past medicalhistory of pathological pregnancies, IgA glomerulonephritis and the absence of risk factors for ischemicheart disease we considered antiphospholipid syndrome (APS) as a possible cause. APS is a systemicautoimmune disease with an increased risk of recurrent arterial and venous thrombosis and pregnancycomplications. After the confirmation of APS in our patient, caused in her case by lupus erythematosus,an effective antithrombotic and immunosuppressive treatment was initiated in order to reduce the risk offuture thrombotic events. Still open is the question of the most optimal antithrombotic treatment for thesepatients because of the lack of evidence from randomized clinical trials.