title: Metachronous thromboses and myocardial infarctions in a 32-year-old woman with antiphospholipid antibodies.
abstract: Metachronous thromboses in multiple vascular beds in a patient younger than 40 years is often suggestive of an acquired or congenital thrombophilic disorder. We present the case of a 32-year-old African American woman who presented to the emergency room with a painful right neck mass and a right hemispheric transient ischemic attack. She had 2 prior admissions for recurrent myocardial infarctions, hypertensive crises, congestive heart failure, and a left ventricular thrombus. Her warfarin therapy expired 2 weeks before her current admission. Our expanded evaluation for thrombophilia revealed high antiphospholipid antibody levels. High-dose anticoagulants were administered without further recurrence or complications. The antiphospholipid antibody syndrome should be considered early in the differential diagnosis as an important cause of recurrent, unusual, or unexplained thromboses in young patients. Education and patient compliance are vital to successful long-term medical management.
authors.affiliation: Morehouse School of Medicine, Department of Surgery, Atlanta, GA 30310-1495, USA.
authors.forename: Irwin M
authors.initials: IM
authors.lastname: Best
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Vasandani
authors.forename: Harvey L
authors.initials: HL
authors.lastname: Bumpers
authors.forename: George
authors.initials: G
authors.lastname: Rust
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology*; D019547:Neck Pain / Q000209:etiology; D010349:Patient Compliance; D012008:Recurrence; D013927:Thrombosis / Q000209:etiology*; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin