Antiphospholipid syndrome a rare aetiology of myocardial infarction in young adults : (reports of three cases and literature review)‎

Abstract EN

We report the observations of 3 young adults (1 woman and 2 men), admitted in our acute care unit for acute myocardial infarction (AMI).

A coagulopathy work-up concludes to antiphospholipid syndrome (APLS) in the 3 cases.

APLS syndrome was considered primary in 2 cases and secondary to a dermatopolymyosite in one case.

All patients presented an intense inflammatory syndrome.

Anticardiolipine were present in the 3 cases.

Whereas, The B2 microglobulines were detected in only one case.

Emergency percutaneous transluminal coronary angioplasty (PTCA) with direct stenting could be performed successfully only in the first case, and the follow-up was uncomplicated.

The patient was diagnosed with primary APS.

Thereafter, long-term oral anticoagulant appeared to be effective.

In the second case emergency coronarography detected diffuse thrombi in the left coronary artery that could not be recanalised with angioplasty, thus only intensive anticoagulant and antiplatelet therapy were performed, high doses of corticosteroids were also necessary for recovery.

Secondary antiphospholipid syndrome to dermatopolymyosite was diagnosed.

The last patient was admitted because of peripheral acute ischemia of legs.

Standard electrocardiogram showed signs of previous silent anteroseptal wall myocardial infarction confirmed by echocardiography.

This latter revealed an apical thrombus and a very low left ventricular ejection fraction.

Amputation of the right leg was necessary because of so late consultation.

However he died four weeks later.