신증후군의 재발과 함께 발생된 관상동맥 혈전증에 의한 급성 심근경색

Vascular thrombosis is one of the most serious complications in patients with nephrotic syndrome. but thrombosis occurs mainly in venous system. Ar terial thrombosis is much less common and coronary artery thrombosis is rarely reported worldwide. We experienced a case of an acute myocardial infarction due to coronary artery thrombosis in a young male with minimal change disease during nephrotic relapse. This 35 year-old male was diagnosed to have minimal change nephrotic syndrome 15 years before admission. Two days before admission, he was found to have heavy proteinuria and edema which led to impression of relapse of nephrotic syndrome. Acute myocardial infarction was developed one day before admission and emergency thrombolytic therapy was performed. After admission, coronary angiography was performed and multiple thrombi were identified in distal left anterior descending artery without marked atherosclerotic changes. The formation of intracoronary thrombi in this patient appeared to be due to the hypercoagulable state associated with the relapse of nephrotic syndrome.