A 28-year-old man diagnosed with triple positive antiphospholipid syndrome (APS) and undergoing warfarin experienced three separate admissions to the cardiac ward within a one-month period due to escalating chest pain. While the initial two admissions revealed normal results in cardiological investigations, such as blood tests, electrocardiogram, and echocardiography, the third admission unveiled signs of ST-elevation myocardial infarction (STEMI), despite the patient maintaining an INR (International Normalized Ratio) of 4. Subsequent percutaneous coronary intervention (PCI) exposed spontaneous coronary artery dissection (SCAD) of type 3. Faced with hemodynamic instability and worsening symptoms, the patient underwent stenting and was prescribed dual antiplatelet therapy in addition to warfarin. A follow-up evaluation one month later indicated a normalization of his condition.
Keyphrases
- percutaneous coronary intervention
- antiplatelet therapy
- st elevation myocardial infarction
- coronary artery
- st segment elevation myocardial infarction
- acute coronary syndrome
- acute myocardial infarction
- atrial fibrillation
- coronary artery disease
- coronary artery bypass grafting
- case report
- pulmonary artery
- left ventricular
- coronary artery bypass
- computed tomography
- pulmonary hypertension
- oral anticoagulants
- physical activity
- sleep quality
- direct oral anticoagulants