Highlights the potential synergistic role of thrombophilic polymorphisms, smoking, and oral contraceptives in the development of acute myocardial infarction in young women.
Should not alter management of young women with ACS; hypothesis-generating case leaves causal role of polymorphisms open.
We present the case of a 28-year-old woman who was admitted to our cardiology unit for acute coronary syndrome. Her history was notable for cardiovascular disease familiarity, active smoking, and oral contraceptive use. On further analysis, she was noted to have thrombophilic polymorphisms involving the plasminogen activator inhibitor (PAI), angiotensin-converting enzyme (ACE), and methylenetetrahydrofolate reductase (MTHFR) genes. We discuss the implications that these cofactors may have had in the genesis of the disease.
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Russo et al. (2014) studied this question.
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