Acute ST-elevation myocardial infarction in a young patient with antiphospholipid syndrome

Abstract

Acute coronary syndrome rarely occurs in young individuals and is seldomly associated with antiphospholipid syndrome. We report the case of a 26-year-old Hispanic man who presented with acute ST-elevation myocardial infarction and was treated with urgent percutaneous transluminal coronary angioplasty. He experienced stent thrombosis within 48 h of intervention and subsequently developed a left apical thrombus. Hypercoagulable state studies were obtained at admission and 12 weeks after the event establishing the diagnosis of antiphospholipid syndrome.

Unveiling Complexity: A Case Report of Catastrophic Antiphospholipid Syndrome With Coronary Occlusion and a Concomitant Patent Foramen Ovale Shunt

“…One of the critical challenges in this case was the coexistence of APLS and SLE, as these autoimmune disorders often overlap and potentiate each other's clinical manifestations. The development of ACS in a young patient with CAPS is rare, emphasizing the need for increased awareness of potential cardiovascular complications in this population [6].…”

“…The initiation and titration of anticoagulation regimens are paramount but must be approached with caution, considering the patient's hypercoagulable state and potential bleeding risks [7]. Recent guidelines have emphasized the importance of tailoring anticoagulation therapy to the specific presentation of CAPS, considering the extent and type of thrombotic events and the presence of comorbidities [6]. As seen in this case, therapeutic decisions require clinical judgment and adaptability, such as deferring therapeutic hypothermia due to hypercoagulability and adjusting anticoagulant dosing following an acute blood loss anemia episode.…”