CASE REPORT
Essential trombocytaemia as cause of myocardial infarction
A. Derks, M.H. Bloemer
Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythaemia (ET). Rarely this can lead to an acute myocardial ischaemic syndrome.' We describe a young patient with a myocardial infarction, in whom ET was found as the probable cause. We discuss the clinical presentation of ET and the therapeutic possibilities. (Neth Heart J 2001;9: 383-5.) Key words: essential thrombocythaenia, myocardial infarction, treatment Case A 21-year-old male with no previous cardiac history was seen in the emergency room because of a threeday history of severe chest pain, which started acutely and was associated with nausea and vomiting. The pain was interpreted as myogenic and treated with NSAIDs by the general practitioner. The history revealed no abnormalities, except the use of XTC a week before. Physical examination showed a Moroccan man with a tachycardia and a blood pressure of 120/80 mmHg. His lungs were clear to auscultation. Cardiac examination revealed normal first and second heart sounds and a fourth heart sound. There were no clicks or murmurs. No hepatosplenomegaly was appreciated. The electrocardiogram revealed a sinus tachycardia, small voltages in the standard leads, Q waves and ST elevations in all leads (figure 1). On arrival, the laboratory data showed elevated heart
enzymes with an LDH: 2718 U/L (normal
Essential trombocytaemia as cause of myocardial infarction
A. Derks, M.H. Bloemer
Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythaemia (ET). Rarely this can lead to an acute myocardial ischaemic syndrome.' We describe a young patient with a myocardial infarction, in whom ET was found as the probable cause. We discuss the clinical presentation of ET and the therapeutic possibilities. (Neth Heart J 2001;9: 383-5.) Key words: essential thrombocythaenia, myocardial infarction, treatment Case A 21-year-old male with no previous cardiac history was seen in the emergency room because of a threeday history of severe chest pain, which started acutely and was associated with nausea and vomiting. The pain was interpreted as myogenic and treated with NSAIDs by the general practitioner. The history revealed no abnormalities, except the use of XTC a week before. Physical examination showed a Moroccan man with a tachycardia and a blood pressure of 120/80 mmHg. His lungs were clear to auscultation. Cardiac examination revealed normal first and second heart sounds and a fourth heart sound. There were no clicks or murmurs. No hepatosplenomegaly was appreciated. The electrocardiogram revealed a sinus tachycardia, small voltages in the standard leads, Q waves and ST elevations in all leads (figure 1). On arrival, the laboratory data showed elevated heart
enzymes with an LDH: 2718 U/L (normal
