Spontaneous coronary artery dissection in a young patient with antiphospholipid syndrome

Ai Phi Thuy Ho; Eirik Tjønnfjord; Oliver Meyerdierks; Ellen Elisabeth Brodin

doi:10.1186/s12959-023-00573-5

Spontaneous coronary artery dissection in a young patient with antiphospholipid syndrome

Thromb J. 2024 Jan 17;22(1):13. doi: 10.1186/s12959-023-00573-5.

Authors

Ai Phi Thuy Ho¹, Eirik Tjønnfjord², Oliver Meyerdierks³, Ellen Elisabeth Brodin⁴

Affiliations

¹ Department of Cardiology, Kalnes Hospital, Kalnesveien 300 Grålum, P.O. Box 300, 1714, , Sarpsborg, Norway. ai.phi.thuy.ho@so-hf.no.
² Department of Emergency Medicine, Kalnes Hospital, Sarpsborg, Norway.
³ Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
⁴ Department of Hematology, Akershus University Hospital, Lørenskog, Norway.

Abstract

A 28-year-old man diagnosed with triple positive antiphospholipid syndrome (APS) and undergoing warfarin experienced three separate admissions to the cardiac ward within a one-month period due to escalating chest pain. While the initial two admissions revealed normal results in cardiological investigations, such as blood tests, electrocardiogram, and echocardiography, the third admission unveiled signs of ST-elevation myocardial infarction (STEMI), despite the patient maintaining an INR (International Normalized Ratio) of 4. Subsequent percutaneous coronary intervention (PCI) exposed spontaneous coronary artery dissection (SCAD) of type 3. Faced with hemodynamic instability and worsening symptoms, the patient underwent stenting and was prescribed dual antiplatelet therapy in addition to warfarin. A follow-up evaluation one month later indicated a normalization of his condition.

Keywords: Antiphospholipid syndrome; Chest pain; Percutaneous coronary intervention; Spontaneous coronary artery dissection.