title: The two hit hypothesis in the antiphospholipid syndrome: acute ischaemic heart involvement after valvular replacement despite anticoagulation in a patient with secondary APS.
abstract: A patient with the antiphospholipid syndrome (APS), in whom a nonfatal myocardial infarction ensued after valvular heart replacement despite anticoagulation, is described. The report further stresses the role of concomitant risk co-factors in inducing thrombotic events and points out that cardiosurgery might represent a potential major risk for myocardial ischaemic damage in APS.
authors.affiliation: Department of Internal Medicine, Azienda Ospedaliera S. Gerardo, Presidio Ospedaliero 'Bassini', Cinisello Balsamo, Milan, Italy. g.bordin@bassini.hsgerardo.org
authors.forename: G
authors.initials: G
authors.lastname: Bordin
authors.forename: R
authors.initials: R
authors.lastname: Boldorini
authors.forename: P L
authors.initials: PL
authors.lastname: Meroni
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000925:Anticoagulants / Q000008:administration & dosage; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis; D005112:Extracorporeal Circulation / Q000009:adverse effects; D005260:Female; D006324:Heart Arrest, Induced / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D009203:Myocardial Infarction / Q000209:etiology*; D011183:Postoperative Complications; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications
chemical_list: D000925:Anticoagulants