Acute Myocardial Infarction in a Patient of Polycythaemia Vera

Abstract

Polycythaemia Vera is the most common form of myeloproliferative neoplasm.The median age of diagnosis is 60 years. Atherosclerosis is the most common cause of myocardial infarction, however other causes too should be looked for in the patients. Here, we present a case of 62 year old female who was a known case of hypertension and Ischemic heart disease on regular medications. She came with complaints of chest pain for the past 2 days. ECG showed NSTEMI with raised cardiac enzymes. She developed left side hemiparesis after admission, and the CT head showed acute infarct in right frontal lobe. She was started on treatment for NSTEMI and cerebrovascular event. Her CBC showed Hb-17.1g/dl, TLC-51600/mm3 and platelet count-625000/mm3, hence we suspected her to have polycythemia Vera with trilineage involvement. Serum erythropoietin was normal. JAK2(V617) profile was positive for homozygous (TT) mutation. Bone marrow biopsy findings were suggestive of trilineage hyperplasia. She was diagnosed as a case of polycythemia Vera. Our patient came into the age group wherein various risk factors for ischemic heart disease could be present like hyperlipidaemia, hypertension, diabetes mellitus but a careful look out for other causes too should be kept in mind.