Key result
A 40-year-old woman with essential thrombocythaemia and elevated anti-cardiolipin IgM antibodies experienced recurrent non-ST elevation myocardial infarction in the postpartum period.
Case Report (n=1)
Rare conditions like essential thrombocythaemia combined with transient antiphospholipid antibodies should be considered in pregnant or postpartum women presenting with acute myocardial infarction.
Normal pregnancy corresponds to a procoagulant state. Acute myocardial infarction during pregnancy is rare, yet considering the low non-pregnant risk score of childbearing women it is still surprisingly frequent. We report a case of postpartum recurrent non-ST elevation myocardial infarction in a 40-year-old caucasian woman with essential thrombocythaemia in the presence of a positive JAK-2 mutation and an elevated anti-cardiolipin IgM antibody titer. In the majority of cases of myocardial infarction in pregnancy or in the peripartal period, atherosclerosis, a thrombus or coronary artery dissection is observed. The combination of essential thrombocythaemia and elevated anti-cardiolipin IgM antibody titer in the presence of several cardiovascular risk factors seems to be causative in our case. In conclusion, with the continuing trend of childbearing at older ages, rare or unlikely conditions leading to severe events such as myocardial infarction must be considered in pregnant women.
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Arampatzis et al. (2010) conducted a case report in Essential thrombocythaemia and acute myocardial infarction (n=1). Essential thrombocythaemia was evaluated. A 40-year-old woman with essential thrombocythaemia and elevated anti-cardiolipin IgM antibodies experienced recurrent non-ST elevation myocardial infarction in the postpartum period.
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