Acute myocardial infarction is usually caused by rupture of an atheromatous plaque in the coronary arteries. For patients without risk factors of atherosclerosis, other causes should be considered. We report on a 47-year-old woman with acute myocardial infarction but no cardiovascular risk factors, which was followed by deep vein thrombosis one week after recovery from acute myocardial infarction. Although deep vein thrombosis may be medically addressed by prolonged bed rest or heart failure in patients with acute myocardial infarction, the clustering of these two diseases in patients without risk factors of atherosclerosis or venous thrombosis is unusual. In situ coronary thrombosis secondary to hypercoagulable state was presumed to be the cause for her myocardial infarction. Further investigation revealed hidden advanced ovarian cancer in the patient. This case should remind cardiologists that, for patients without clinical evidence of atherosclerosis, unusual underlying causes of acute myocardial infarction should be comprehensively investigated, such as malignancy-related hypercoagulable state.
Key words: Deep vein thrombosis; Hypercoagulability; Myocardial infarction; Ovarian cancer; Trousseau's syndrome.