Abstract
Essential thrombocythemia (ET) is a proliferative disorder of mature myeloid which may lead to persistently elevated platelet count. The clinical manifestations of ET include hemorrhagic and thrombotic complications, especially thrombus in the cerebral and peripheral arteries. However, coronary artery thrombosis in ET patient is rare. In this article, we report a 78-year-old woman who presented with acute myocardial infarction (AMI) as the first clinical sign of ET. Diagnostic coronary angiography revealed acute occlusion of the right coronary artery and percutaneous aspiration thrombectomy was performed successfully. The patient then received hydroxycarbamide and prednisone under supervision of a haematologist. She recovered very well during a follow-up more than three months. With this case, we hope that clinicians would always keep in mind that ET is an unusual cause of AMI and the patients with ET should be informed about the risk of fatal cardiac events.
Highlights
Essential thrombocythemia (ET) is a proliferative disorder of mature myeloid which may lead to persistently elevated platelet count [1]
A V617F mutation in the gene encoding Janus kinase 2 (JAK2) in hematopoietic progenitor cells is usually found positive in ET patients
We report a 78-year-old woman who presented with acute myocardial infarction (AMI) as the first clinical sign of ET
Summary
Essential thrombocythemia (ET) is a proliferative disorder of mature myeloid which may lead to persistently elevated platelet count [1]. The incidence rate for ET is about 2.5 to 3.0 cases per 105 populations per year. The clinical manifestations of ET include hemorrhagic and thrombotic complications, especially thrombotic complications in the cerebral, coronary, and peripheral vessels [2,3]. Both thrombosis and hemorrhage result from qualitative and quantitative defects of the platelets. Coronary artery thrombosis in ET patient is rare. Acute myocardial infarction (AMI) caused by ET is often misdiagnosed because of its atypical symptoms and low incidence [4]. We shared a case who presented with AMI as the first clinical sign of ET
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