Multivessel coronary thrombosis, acute myocardial infarction, and no reflow in a patient with essential thrombocythaemia

Abstract

Essential thrombocythaemia (ET) has been reported rarely to cause coronary thrombosis, but the management is still undefined. A 63 year old woman with multivessel coronary thrombosis, acute myocardial infarction (MI), and no reflow in reperfused coronary artery in association with ET is presented. The patient's platelet count was only moderately raised at the onset of MI, but peripheral blood smear and bone marrow evaluation revealed clumping giant platelets and numerous large hyperploid megakaryocytes. Long term prophylaxis with antiplatelet agents in patients with ET is recommended, even if the platelet count is not largely raised. Cytoreductive treatment may also be eVective for secondary prevention when thrombotic complications occur. (Heart 2000;83:e10)

Essential Thrombocythemia: A Case of Acute ST‐Segment Elevation Myocardial Infarction in a Young Female

“…We could find only 7 cases of MI in female patients with ET in the literature and the age of all these patients was older than our patient. 4,5 Similar to our patient, the LAD artery was occluded in most of the patients presented with MI and ET.…”

Multiple coronary thrombosis and stent implantation to the subtotally occluded right renal artery in a patient with essential thrombocytosis: A case report with review

“…Fewer than 20 cases of essential thrombocytosis with involvement of coronary arteries leading to acute coronary syndromes or myocardial infarction have been reported [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The association between essential thrombocytosis and coronary artery disease was first reported by Saffitz et al [12].…”

“…The majority of the case reports about essential thrombocytosis and acute coronary syndromes/acute myocardial infarction are due to the occlusion of the left anterior descending artery [16]. The left anterior descending artery was reported to be involved in ten patients [12][13][14]16,17,19,21,22,25,26] and the right coronary artery [12,14,17,18] was involved in four patients. The left main coronary artery was involved in three patients [18,23,24].…”

Acute Simultaneous Thrombotic Occlusion of Multiple Coronary Arteries in Acute Myocardial Infarction: A Case Report

“…Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in STEMI (3), and is usually associated with cardiogenic shock and dangerous arrhythmia (4). Facilitating factors to create multiple coronary thrombosis includes coronary vasospasm (5, 6), cocaine abuse (7), higher likelihood of thrombosis such as in heparin induced thrombocytopenia (8), antithrombin III deficiency (9), idiopathic thrombocytopenic purpura (10), hormonal therapy such as tamoxifen (11) as well as thrombophilias such as antiphospholipid antibodies, factor V Leiden deficiency, essential thrombocythemia, and hyper-homocysteinemia (12)(13)(14)(15)(16). Coronary embolism from cardiac chamber is another source of the simultaneous multiple coronary artery thrombosis.…”