A patient with essential thrombocythemia may have an acute myocardial infarction (AMI) during the course of the illness.
The diagnosis of essential thrombocytosis should be considered in a young patient with no apparent risk factors for coronary artery disease, especially if the platelet count is elevated.
The hypercoagulable state can occur even in the absence of significant thrombocytosis.
If the platelet count and hypercoagulable state are not managed, then recurrent myocardial infarctions can be expected.
Management involves:
(1) Control of the platelet count with hydroxyurea or other chemotherapy.
(2) Therapy with an antiplatelet drug such as a glycoprotein IIb/IIIa receptor inhibitor.
(3) Discontinuation and avoidance of smoking.
(4) Management of atherosclerotic risk factors.
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