International Journal of Cardiovascular Sciences. 05/Mar/2021;34(2):236-9.
Acute Myocardial Infarction as the Initial Clinical Manifestation of Pernicious Anemia
Leonardo Marostica Alves Silva
, Assis Xavier da Silva Barros Junior
, João Antonio de Toledo Galina
, Alexandre Rodrigues
, Igor Ribeiro de Castro Bienert
, Pedro Beraldo de Andrade
Introduction
Despite its lower prevalence in young individuals, acute myocardial infarction (AMI) causes significant morbidity and socioeconomic impact when occurs in this group. In 2010, considering only the hospitals accredited by the Brazilian Unified Health System, there were 8,368 hospitalizations and 2,556 deaths from ischemic heart diseases among patients younger than 40 years. Although hospitalization rates are lower at this age range, the importance of this theme lies mainly in the absolute numbers of cases.
Acute coronary syndrome (ACS) in young patients has characteristics that differ from older patients. Although coronary atherosclerotic disease is a common cause, the prevalence of AMI without obstruction in the coronary arteries is higher among the young. Among the causes of AMI without atheromatous disease, thromboembolism is a differential diagnosis, with hypercoagulability correlated with formation of coronary embolism. Thus, it is important to identify alternative etiologies in the approach of AMI in young patients since modifiable factors can be diagnosed and treated. In this article, we present a case in which an autoimmune disease may be the cause of ACS in a young patient with few attributable risk factors for cardiovascular disease.
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