Antiphospholipid antibody syndrome causing acute myocardial infarction in a young adult

Abstract

Myocardial infarction (MI) is more frequent in patients older than 45 years of age; however, it can occur in young patients and it is important to include in the differential diagnosis of chest pain. In this case, a 29-year-old male presented to the emergency department with chest pressure. Electrocardiography revealed an acute ST elevation MI. The patient was found to have a mixed hypercoagulability disorder, including antiphospholipid (aPL) antibody syndrome, which led to the infarction. aPL antibody syndrome is a common cause of acquired hypercoagulability in the general population. It is a clinical syndrome characterized by repeated arterial and venous thrombosis, recurrent fetal loss, and positive antibody tests. Asymptomatic patients with low titer aPL antibodies require no treatment. Asymptomatic patients with moderate to high titer aPL antibodies are managed with low-dose aspirin, as are patients with a history of pregnancy-related complications. Patients with more severe manifestations, such as venous or arterial thrombosis, are managed with lifelong administration of warfarin.