Primary Antiphospholipid Antibody Syndrome Presenting as Acute Myocardial Infarction.

A 46-year-old woman with no significant past history presented to the emergency department with history of sudden-onset central chest discomfort and diaphoresis. With a preliminary diagnosis of acute myocardial infarction, she was subjected to coronary angiography, which showed occlusion of the distal left anterior descending artery with otherwise normal epicardial coronary arteries. Aspiration was performed in the vessel and yielded pinkish friable tissue. The histopathological examination revealed fibrin-rich thrombus. The patient was treated with enoxaparin and switched to oral anticoagulation with warfarin. On follow-up, the nodular mass on the mitral valve reduced considerably in size and she was advised that life-long anticoagulation was necessary.