The mystery of recurrent idiopathic cerebrovascular and coronary arterial thrombosis

BMJ Case Rep. 2014 Nov 24:2014:bcr2014205430. doi: 10.1136/bcr-2014-205430.

Abstract

A 46-year-old man presented to our hospital with ST elevation myocardial infarction (STEMI). Previous records revealed a history of recurrent non-STEMI, stroke and transient ischaemic attacks. He was thoroughly investigated with coronary angiography, a cerebral CT angiography, thrombophilia panel and autoimmune screening tests, all of which proved negative. His current episode of STEMI resulted while on dual antiplatelet therapy; the patient was investigated for P2Y12 receptor resistance, which was also negative. A diagnosis of idiopathic recurrent arterial thrombosis was established and the patient was discharged home on aspirin and warfarin. Routine follow-up has revealed no recurrence of symptoms.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • Aspirin / therapeutic use
  • Brain Ischemia / drug therapy
  • Brain Ischemia / etiology*
  • Coronary Thrombosis / complications*
  • Coronary Thrombosis / diagnosis*
  • Coronary Thrombosis / drug therapy
  • Diagnosis, Differential
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / etiology*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Recurrence
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Aspirin