title: Acute coronary thrombosis and multiple coronary aneurysms in a 22-year-old man with the human immunodeficiency virus.
abstract: The human immunodeficiency virus (HIV) can cause diverse cardiovascular complications. In HIV patients on antiretroviral therapy, the prevalence of myocardial infarction has steadily increased over the years. Young patients who are naïve to antiretroviral therapy and who experience coronary events are not well represented in the medical literature. We describe the case of a 22-year-old man, infected with HIV for 4 years and never treated with antiretroviral therapy, who emergently presented with a non-ST-segment-elevation myocardial infarction. Coronary angiograms revealed thrombosis and multiple coronary artery aneurysms; however, no areas of atherosclerotic stenosis were apparent. He was successfully treated with coronary stenting, antiplatelet therapy, and anticoagulation. Nine months after the initial presentation, he exhibited excellent exercise capacity, and no ischemia was evident. We discuss the various therapeutic approaches in this case.
authors.affiliation: Department of Cardiology (Drs. Ayers, Hsi, Mandell, and Sanghvi), and Division of Infectious Disease (Dr. Aboujaoude), Deborah Heart & Lung Hospital, Browns Mills, New Jersey 08015.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ayers
authors.affiliation: Department of Cardiology (Drs. Ayers, Hsi, Mandell, and Sanghvi), and Division of Infectious Disease (Dr. Aboujaoude), Deborah Heart & Lung Hospital, Browns Mills, New Jersey 08015.
authors.forename: Ryan
authors.initials: R
authors.lastname: Mandell
authors.affiliation: Department of Cardiology (Drs. Ayers, Hsi, Mandell, and Sanghvi), and Division of Infectious Disease (Dr. Aboujaoude), Deborah Heart & Lung Hospital, Browns Mills, New Jersey 08015.
authors.forename: Kintur
authors.initials: K
authors.lastname: Sanghvi
authors.affiliation: Department of Cardiology (Drs. Ayers, Hsi, Mandell, and Sanghvi), and Division of Infectious Disease (Dr. Aboujaoude), Deborah Heart & Lung Hospital, Browns Mills, New Jersey 08015.
authors.forename: Rania
authors.initials: R
authors.lastname: Aboujaoude
authors.affiliation: Department of Cardiology (Drs. Ayers, Hsi, Mandell, and Sanghvi), and Division of Infectious Disease (Dr. Aboujaoude), Deborah Heart & Lung Hospital, Browns Mills, New Jersey 08015.
authors.forename: David H
authors.initials: DH
authors.lastname: Hsi
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods; D000925:Anticoagulants / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage*; D000077144:Clopidogrel; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D017023:Coronary Angiography / Q000379:methods; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004562:Electrocardiography; D006678:HIV / Q000472:pathogenicity; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Anticholesteremic agents/therapeutic use; HIV infections/complications; anticoagulants/therapeutic use; cardiovascular diseases/diagnosis/etiology/therapy; coronary aneurysm/diagnosis/drug therapy/epidemiology/etiology; risk factors; treatment outcome; vasculitis/physiopathology/virology