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What cardiologists should know about essential thrombocythemia and acute myocardial infarction: report of two cases and advanced heart failure therapies considerations

Authors Soucy-Giguère MC, Turgeon PY, Sénéchal M

Received 29 May 2019

Accepted for publication 9 July 2019

Published 8 August 2019 Volume 2019:12 Pages 253—259


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Ronald Prineas

Marie-Camille Soucy-Giguère, Pierre Yves Turgeon, Mario Sénéchal

Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada

Abstract: We present the cases of two young male patients aged 22 and 31 without prior medical history nor cardiovascular risk factors, who presented to the hospital with large anterior ST-elevation myocardial infarction (STEMI). Urgent coronary angiography revealed acute thrombotic occlusion of the proximal left anterior descending artery in both patients. Persistent thrombocytosis was noted and subsequent investigations led to the diagnosis of essential thrombocythemia (ET) with positive JAK2-V617F mutation. Myocardial infarction as a first clinical manifestation of ET is rare but must be considered in patients without cardiovascular risk factors who show persistent thrombocytosis. In young patients without risk factors, there may be great delays before the diagnosis of STEMI is made. Longer time to revascularization of extensive STEMI is associated with adverse outcomes and cardiogenic shock which can lead to advanced therapies like heart transplant and left ventricular assist device (LVAD). Considering the favorable long-term prognosis of patients with ET, advanced therapies may be a valuable option in the presence of severe left ventricular dysfunction.

Keywords: thrombocytosis, JAK2 mutation, heart transplant, left ventricular assist device

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