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Transient Coronary Thrombosis Mimicking Myopericarditis Revealing JAK2-Positive Essential Thrombocythemia.

Created on 05 Aug 2026

Authors

Paisit Kosum, Akenarong Pipatputthapong, Pongpun Jittham, Nattakorn Songsirisuk, Peerapon Wong, Rawisut Deoisares, Koravich Phumviwattanasirikul, Worathon Banlue, Nonthikorn Theerasuwipakorn, Chalinee Pravarnpat

Published in

JACC. Case reports. Pages 109575. Aug 05, 2026. Epub Aug 05, 2026.

Abstract

Acute coronary thrombosis without atherosclerosis may mimic myopericarditis, particularly in young patients.
A 20-year-old woman presented with pleuritic chest pain following a viral illness. Serial electrocardiography showed dynamic ST-segment elevation in leads V3 to V6, and high-sensitivity troponin T increased from 18.6 to 1,151 ng/L. Echocardiography demonstrated regional wall motion abnormalities in the left anterior descending territory. Coronary angiography revealed a proximal left anterior descending intraluminal thrombus causing severe narrowing without underlying atherosclerosis. Conservative management with anticoagulation and dual antiplatelet therapy was initiated. Repeat angiography after 3 days showed complete thrombus resolution with no residual stenosis. Further evaluation revealed marked thrombocytosis and a JAK2 V617F mutation, confirming essential thrombocythemia.
This case highlights a mechanism-based approach to myopericarditis-like presentations. JAK2-positive essential thrombocythemia represents a plausible prothrombotic contributor after the exclusion of common causes of coronary artery disease in very young patients.
Dynamic regional electrocardiogram changes, rapid troponin elevation, and regional wall motion abnormalities should prompt coronary evaluation despite pleuritic symptoms.

PMID:
42554550
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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