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Essential thrombocythaemia first presenting as myocardial infarction in a 36-year-old male
  1. Shahid Bobat1,2 and
  2. Paul Dunne2
  1. 1The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
  2. 2Cardiology Department, Bolton NHS Foundation Trust, Bolton, UK
  1. Correspondence to Dr Shahid Bobat; Shahidbobat{at}


Essential thrombocythaemia (ET) is a myeloproliferative neoplasm where there is a clonal proliferation of thrombocytes. Whilst most often diagnosed incidentally, it can uncommonly present with arterial thrombosis. This is a case presentation of a 36-year-old male who was diagnosed with ET following myocardial infarction caused by multiple thrombotic emboli. The patient was initially misdiagnosed with viral myopericarditis based on an atypical history of chest pain with a viral prodrome. Reattendance a month later with further chest pain, dynamically raised troponin and ECG changes raised suspicions of ACS. Analysis of blood markers from both admissions showed consistently elevated platelet counts. A CMR scan revealed focal ischaemic scars in multiple cardiac segments consistent with an acute coronary event or coronary embolisation. A subsequent coronary angiography demonstrated minimal coronary artery disease. JAK2 gene V617F mutation was detected, confirming ET. The patient was commenced on pegylated interferon-alpha and dual antiplatelet therapy, and discharged with follow-up.

  • ischaemic heart disease
  • haematology (incl blood transfusion)
  • haematology (drugs and medicines)
  • cardiovascular system

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  • Contributors SB and PD are equal contributors. SB acted as the primary author of the manuscript with PD providing supervision and editing of draft versions. SB is first author and PD is second author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.