Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2024; 16(8): 491-495
Published online Aug 26, 2024. doi: 10.4330/wjc.v16.i8.491
Antiphospholipid syndrome presenting as recurrent coronary thrombosis: A case report
Xue-Chen Liu, Wei Wang, Lian-Yi Wang
Xue-Chen Liu, Wei Wang, Lian-Yi Wang, First Hospital of Tsinghua University, School of Clinical Medicine, Tsinghua University, Beijing 100016, China
Lian-Yi Wang, Heart Center, First Hospital of Tsinghua University, Beijing 100016, China
Author contributions: Liu XC prepared the article and collected data; Wang W collected angiography figures; Wang LY reviewed the article and data; all authors have read and approved the final version to be published.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lian-Yi Wang, MD, PhD, Professor, Heart Center, First Hospital of Tsinghua University, No. 6 First Street of Jiuxianqiao, Chaoyang District, Beijing 100016, China. lywang@mail.tsinghua.edu.cn
Received: July 17, 2024
Revised: July 30, 2024
Accepted: August 8, 2024
Published online: August 26, 2024
Processing time: 40 Days and 9.6 Hours
Abstract
BACKGROUND

Antiphospholipid syndrome (APS) is a chronic autoimmune disease characterized by venous or arterial thrombosis, pregnancy morbidity and a variety of other autoimmune and inflammatory complications. Here, we report a case of APS associated with multiple coronary thromboses.

CASE SUMMARY

The patient, a 28-year-old male, suffered from recurrent coronary thromboses over a period of 31 months. Despite undergoing interventional coronary procedures, thrombolytic therapy, and anticoagulation treatment, the condition persisted intermittently. An extensive search for underlying thrombogenic factors revealed a diagnosis of APS. Accurate adjustment of the medication regimen led to the absence of further acute coronary syndrome (ACS) episodes during the subsequent 20-month follow-up. Although the patient occasionally experiences chest tightness, no further symptoms of distress have been reported.

CONCLUSION

APS can manifest as ACS. Screening for rheumatologic and immunological conditions is essential when encountering patients with multiple coronary thromboses. Treatment strategy should include symptomatic relief and a targeted and aggressive approach to address the underlying pathophysiology.

Keywords: Antiphospholipid syndrome; Acute coronary syndrome; Coronary angiography; Lupus anticoagulant; Treatment for antiphospholipid syndrome; Case report

Core Tip: Antiphospholipid syndrome (APS) is primarily identified by its thrombotic phenomena. Thus, healthcare professionals should be highly vigilant for the assorted clinical symptoms that can stem from thromboembolic events, which have the potential to involve several organ systems. When encountering young individuals with frequent angina attacks who do not possess conventional risk factors, it is imperative not to pinpoint the cause solely on cardiac issues. The integration of percutaneous coronary intervention and specific treatment targeting the etiology of APS is essential. The need to preserve a heightened awareness of the spectrum of clinical signs linked to thromboembolic complications affecting diverse organ systems is required.