Paradoxical Mesentery Embolism and Silent Myocardial Infarction in Primary Antiphospholipid Syndrome: A Case Report

Authors

  • Dursun Duman
  • Refik Demirtunc
  • Deniz Duman
  • Faik Sungur
  • Mehmet Agirbasli
  • Mahmut Cakmak

DOI:

https://doi.org/10.1532/hsf.623

Abstract

In this case, we describe a 33-year-old man presenting with acute mesenteric ischemia. When we searched for a source of embolism, a giant right atrial mass and patent foramen ovale was discovered. Standard electrocardiography showed signs of an old, silent anteroseptal wall myocardial infarction, confirmed by echocardiography and left ventriculography. Coronary angiography revealed complete occlusion of the left anterior descending artery. The diagnosis of primary antiphospholipid syndrome was confirmed by anticardiolipin antibodies test. Surgical myocardial revascularization along with the resection of the mass and the closure of the patent foramen ovale were performed. Histological examination of the operative specimen showed a thrombus. This is the first reported case presenting with acute paradoxical mesentery embolism accompanying an old myocardial infarction in a young patient with primary antiphospholipid syndrome.

References

Agirbasli MA, Hansen DE, Byrd BF 3rd. 1997. Resolution of vegetations with anticoagulation after myocardial infarction in primary antiphospho-lipid syndrome. J Am Soc Echocardiogr10:877--80.nAsherson RA, Cervera R. 1994. 'Primary,' 'secondary' and other variants of the antiphospholipid syndrome. Lupus3:293--8.nBaudouy PY, Bouchachi AA, Costedoat-Chalumeau N, et al. 2003. Myocardial infarction revealing an antiphospholipid syndrome in a 27-year-old woman [in French]. Arch Mal Coeur Vaiss96:1231--4.nGezer S. 2003. Antiphospholipid syndrome. Dis Mon49:696--741.nHojnik M, George J, Ziporen L, Shoenfeld Y. 1996. Heart valve involvement (Libman-Sacks endocarditis) in the antiphospholipid syndrome. Circulation93:1579--87.nKattwinkel N, Villanueva AG, Labib SB, et al. 1992. Myocardial infarction caused by cardiac microvasculopathy in a patient with the primary antiphospholipid syndrome. Ann Intern Med116:974--6.nKurz R, Eder A, Buck J, Heinkelein J. 1997. Mesenteric infarct in primary antiphospholipid antibody syndrome [in German]. Z Gastroenterol35:669--72.nLagana B, Baratta L, Tubani L, Golluscio V, Delfino M, Rossi Fanelli F. 2001. Myocardial infarction with normal coronary arteries in a patient with primary antiphospholipid syndrome---case report and literature review. Angiology52:785--8.nLockshin M, Tenedios F, Petri M, et al. 2003. Cardiac disease in the antiphospholipid syndrome: recommendations for treatment. Committee consensus report. Lupus12:518--23.nRoubey RA, Hoffman M. 1997. From antiphospholipid syndrome to antibody-mediated thrombosis. Lancet350:1491--3.nSanchez-Guerrero J, Reyes E, Alarcon-Segovia D. 1992. Primary antiphospholipid syndrome as a cause of intestinal infarction. J Rheumatol19:623--5.nTsutsumi A, Matsuura E, Ichikawa K, et al. 1996. Antibodies to beta 2-glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus. Arthritis Rheum39:1466--74.n

Published

2006-03-15

How to Cite

Duman, D., Demirtunc, R., Duman, D., Sungur, F., Agirbasli, M., & Cakmak, M. (2006). Paradoxical Mesentery Embolism and Silent Myocardial Infarction in Primary Antiphospholipid Syndrome: A Case Report. The Heart Surgery Forum, 9(2), E592-E594. https://doi.org/10.1532/hsf.623

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