Primary antiphospholipid syndrome complicated by recurrent acute ST-elevation myocardial infarction: a case report

Clinical management of primary antiphospholipid syndrome (PAPS) complicated by acute myocardial infarction (AMI) is particularly challenging, especially when recurrent AMI and thrombocytopenia are present. This case report describes a 35-year-old male patient with PAPS who experienced two episodes of acute inferior ST-elevation myocardial infarction (STEMI). Comprehensive diagnostic evaluations including coronary imaging, physiology, immunology, bone marrow morphology, and molecular biology were performed to confirm the diagnosis. A personalized treatment regimen combining clopidogrel, low-molecular-weight heparin, methylprednisolone, hydroxychloroquine, and rituximab was administered, which resulted in a favorable long-term prognosis. This case underscores the importance of a multidisciplinary approach and individualized treatment strategies based on coronary functional assessment for managing patients with PAPS and AMI.