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Lupus
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The two hit hypothesis in the antiphospholipid syndrome: acute ischaemic heart involvement after valvular replacement despite anticoagulation in a patient with secondary APS

G Bordin

Department of Internal Medicine, Azienda Ospedaliera S. Gerardo, Presidio Ospedaliero ‘Bassini’, Cinisello Balsamo, Milan, Italy, g.bordin{at}bassini.hsgerardo.org

R Boldorini

Pathology Service, Ospedale Maggiore della Carità, Novara, Italy

P L Meroni

Allergy and Clinical Immunology Unit, Department of Internal Medicine, University of Milan, Milan, Italy

A patient with the antiphospholipid syndrome (APS), in whom a nonfatal myocardial infarction ensued after valvular heart replacement despite anticoagulation, is described. The report further stresses the role of concomitant risk co-factors in inducing thrombotic events and points out that cardiosurgery might represent a potential major risk for myocardial ischaemic damage in APS.

Key Words: antiphospholipid antibodies • cardiosurgery • heart valvulopathy • ischaemia

Lupus, Vol. 12, No. 11, 851-853 (2003)
DOI: 10.1191/0961203303lu445cr
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