Acute anterior myocardial infarction in a young man with essential thrombocythemia: A case report

Abstract

Essential thrombocythemia is a rare cause of ischemic cardiovascular events. A 23-year-old young man was admitted with chest pain to the coronary care unit. Electrocardiogram revealed acute anterior myocardial infarction (AMI). He had a platelet count 748,000/mm³ and detailed hematologic investigation led to the diagnosis of essential thrombocythemia. Coronary angiography revealed two vessel disease, with 95% stenosis in the middle of left anterior descending artery (LAD), thrombotic occlusion of distal LAD and recanalized thrombus in the right coronary artery (RCA). Apical akinesia and anterolateral hypokinesia was present by left ventriculography. In the same session, glycoprotein IIb/IIIa receptor antagonist drug (tirofiban) therapy was started and after 4 × 16 mm NIR primo stent was implanted in the middle of the LAD. With aspirin 300 mg/day and ticlopidine 500 mg/day therapy, platelet count was found to be around 530,000–550,000/mm³. Clinical follow-up of the patient showed no chest pain. Six months after angioplasty, stent in the LAD and distal of LAD was found to be open with control coronary angiography. Recanalized thrombus in RCA showed no difference. Medical follow up is decided. We decided to report this case since essential thrombocythemia is a rare disease that may result in serious life-threatening cardiovascular complication.