BMJ Case Reports 2014; doi:10.1136/bcr-2013-203499

Rapidly progressive coronary artery disease as the first manifestation of antiphospholipid syndrome

  1. Caroline Daly2
  1. 1Department of Cardiology, University Hospital Limerick, Limerick, Ireland
  2. 2Department of Cardiology, St James Hospital, Dublin, Ireland
  1. Correspondence to Dr Abdullah Sayied Abdullah, abdalasayid{at}
  • Accepted 9 March 2014
  • Published 8 April 2014


Antiphospholipid syndrome (APS) is an autoimmune multisystem disorder characterised by high incidence of arterial and venous thrombosis. Cardiovascular manifestations also include valvular heart disease, ventricular thrombi and higher risk for coronary artery disease (CAD). In this case report, we describe a 61-year-old woman who had no significant risk factors for CAD, and presented with aggressive disease in native and graft vessels that required multiple coronary interventions. The extent of her aggressive CAD could not be explained by her risk factors profile. Therefore autoantibodies screening was carried out and showed a strongly positive anticardiolipin and β2 glycoprotein-I antibody, and hence a diagnosis of antiphospholipid syndrome was made.

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