Acute myocardial infarction in a young woman with antiphospholipid syndrome and occasional cocaine abuse.
We describe a case of acute myocardial infarction in a 19-year-old woman reporting a history of occasional cocaine abuse with last exposure 4 days before symptom onset, otherwise at low cardiovascular risk. Coronary angiography showed thrombotic occlusion of anterior descending coronary artery without atherosclerotic plaques, and complete recanalization of the vessel after anticoagulation with enoxaparine. Hypercoagulability evaluation revealed the presence of antiphospholipid antibodies. We suppose that cocaine abuse may have had a delayed effect as trigger of acute myocardial infarction. This action may be due to cocaine-induced endothelial activation and to a synergic prothrombotic activity of cocaine and antiphospholipid antibodies.
Raddino
Riccardo
R
Pedrinazzi
Claudio
C
Zanini
Gregoriana
G
Procopio
Roberto
R
Dei Cas
Livio
L
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000276:immunology; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology; D019970:Cocaine-Related Disorders / Q000150:complications*; D017023:Coronary Angiography; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D015912:Thrombolytic Therapy / Q000379:methods
D017152:Antibodies, Antiphospholipid; D017984:Enoxaparin; D005343:Fibrinolytic Agents