What is the clinical evidence from this study?

Study design: Case Report. Population: Acute myocardial infarction (n=1). Intervention: Combined oral contraceptive (levonorgestrel and ethinyl estradiol). Primary outcome: Acute myocardial infarction.

What does this research mean for the field?

Combined oral contraceptive use can precipitate acute thrombotic myocardial infarction in young women even in the absence of traditional cardiovascular risk factors or underlying atherosclerosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a rare presentation of acute myocardial infarction caused by arterial thrombosis in a young woman using combined oral contraceptives in the absence of conventional cardiovascular risk factors.

June 19, 2026Journal of Medical Case ReportsOpen Access

Combined oral contraceptive use as a cause of acute myocardial infarction in a young woman without traditional risk factors: a case report

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Key result

Long-term combined oral contraceptive use linked to thrombotic AMI in a 28-year-old without traditional risk factors.

Why the study?

Combined oral contraceptives are linked to arterial thrombosis, but literature is limited regarding their potential to induce myocardial infarction in individuals lacking traditional cardiovascular risk factors.

Population

A 28-year-old non-smoking Iranian woman without cardiovascular risk factors presenting with acute myocardial infarction

Design

Case report

Follow-up

3 months

Authors

SHSeyed Kianoosh HosseiniHamedan University of Medical Sciences HMHosseinali MohammadiHamedan University of Medical Sciences SMSeyyed Alireza MohammadiShahid Beheshti University of Medical Sciences

Discussion

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Implication

May prompt consideration of combined oral contraceptives as MI trigger in low-risk young women; extends limited case evidence and supports further study.

Key Points

To report a rare presentation of acute myocardial infarction caused by arterial thrombosis in a young woman using combined oral contraceptives in the absence of conventional cardiovascular risk factors.
Evaluated a 28-year-old non-smoking Iranian woman presenting with 11 hours of anginal chest pain after 13 years of using a combined oral contraceptive containing 150 µg levonorgestrel and 30 µg ethinyl estradiol.
Performed emergent coronary angiography, plain old balloon angioplasty with a 2.0 × 12 mm balloon without stent placement, and post-discharge screening for inherited and acquired thrombophilia.
Coronary angiography revealed total thrombotic occlusion in the mid-left anterior descending artery without underlying atherosclerosis; plain balloon angioplasty restored TIMI 3 flow and resolved symptoms without stenting.
Comprehensive thrombophilia screening—including protein C, protein S, antithrombin III, factor V Leiden, prothrombin G20210A, antiphospholipid antibodies, and homocysteine—showed entirely normal results.
At 3-month follow-up after contraceptive discontinuation, computed tomography angiography confirmed a patent left anterior descending artery without stenosis, and echocardiography showed left ventricular ejection fraction improvement from 45% to 50–55%.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 28-year-old Iranian woman with no traditional cardiovascular risk factors who presented with an acute myocardial infarction after 13 years of combined oral contraceptive use.

Exposure

Second-generation combined oral contraceptive containing 150 µg levonorgestrel and 30 µg ethinyl estradiol for 13 years; emergent coronary angiography and balloon angioplasty without stenting

Outcome

Thrombotic occlusion in the mid-left anterior descending artery without evidence of underlying atherosclerosishard clinical

This case highlights the potential for combined oral contraceptives to cause thrombotic myocardial infarction in young women without traditional risk factors, and demonstrates the potential efficacy of balloon angioplasty without stenting for non-atherosclerotic thrombotic occlusion.

Limitations

Single case report, so causality between combined oral contraceptive use and myocardial infarction cannot be definitively established

Cite This Study

Hosseini et al. (2026) conducted a case report in Acute myocardial infarction (n=1). Combined oral contraceptive (levonorgestrel and ethinyl estradiol) was evaluated on Acute myocardial infarction. A 28-year-old woman without traditional cardiovascular risk factors developed a thrombotic acute myocardial infarction after 13 years of using a second-generation combined oral contraceptive.

synapsesocial.com/papers/6a359850dd3be7785e70ed97 https://doi.org/10.1186/s13256-026-06192-8

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Implication

May prompt consideration of combined oral contraceptives as MI trigger in low-risk young women; extends limited case evidence and supports further study.

Combined oral contraceptive use as a cause of acute myocardial infarction in a young woman without traditional risk factors: a case report

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Combined oral contraceptive use as a cause of acute myocardial infarction in a young woman without traditional risk factors: a case report

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider