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World J Cardiol. Aug 26, 2011; 3(8): 278-280
Published online Aug 26, 2011. doi: 10.4330/wjc.v3.i8.278
Published online Aug 26, 2011. doi: 10.4330/wjc.v3.i8.278
Coronary spasm-related acute myocardial infarction in a patient with essential thrombocythemia
Chi-Wen Cheng, Ming-Jui Hung, Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung City 20401, Taiwan, China
Author contributions: All authors contributed equally to the paper.
Correspondence to: Ming-Jui Hung, MD, PhD, Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung, 222 Maijin Road, Keelung City 20401,Taiwan, China. miran888@ms61.hinet.net
Telephone: +886-2-24313131-3168 Fax: +886-2-24335342
Received: April 29, 2011
Revised: July 18, 2011
Accepted: July 25, 2011
Published online: August 26, 2011
Revised: July 18, 2011
Accepted: July 25, 2011
Published online: August 26, 2011
Abstract
We report a case of essential thrombocythemia (ET) in a 30-year-old female who exhibited inferior wall ST-elevation acute myocardial infarction (AMI) without significant obstructive coronary artery disease. Right coronary vasospasm was observed after intra-coronary methylergonovine administration and she received verapamil 120 mg/d
thereafter and hydroxyurea 1500 mg/d for thrombocythemia. After discontinuation of the hydroxyurea for 9 mo based on the impression of coronary spasm-related instead of coronary thrombosis-related AMI, her platelet count rose but no chest pain was observed. It is suggested that coronary spasm potentially plays a role in patients with ET, AMI and no significant coronary artery stenosis.