POSTPARTUM MYOCARDIAL-INFARCTION IN A PATIENT WITH ANTIPHOSPHOLIPID SYNDROME

Myocardial infarction in association with pregnancy in patients with t he antiphospholipid syndrome has been reported once previously. Our pa tient, a 22-year-old multiparous woman, experienced a myocardial infar ction in the postpartum period. She fulfilled the criteria for the dia gnosis of the antiphospholipid syndrome (elevated anticardiolipin anti body levels, false-positive syphilis serology, history of deep vein th rombosis). Cardiac catheterization demonstrated appropriate central fi lling pressures, cardiac output of 7.14 L/min, and normal-appearing co ronary arteries. She was treated with corticosteroids and indomethacin and recovered. Our article is relevant to clinical practice for the f ollowing reasons. First, it is the second time myocardial necrosis has been reported in a recently pregnant woman with the antiphospholipid syndrome. Second, the finding of normal-appearing coronary arteries at the time of catheterization lends credence to the hypothesis that eit her vasospasm or thombosis are the inciting events. We speculate on th e utility of various treatment regimens.