ST-Segment Elevation Myocardial Infarction in a Patient With Myasthenia Gravis After Intravenous Immunoglobulin Infusion.

BACKGROUND

Acute coronary syndrome is rare in patients with myasthenia gravis, with only limited literature available. We report an atypical case of ST-segment elevation myocardial infarction (STEMI) that occurred after intravenous immunoglobulin (IVIg) infusion in a patient with myasthenia gravis.

CASE SUMMARY: A 36-year-old woman with a longstanding history of myasthenia gravis developed acute chest pain and ST-segment elevation on electrocardiogram after IVIg administration. Emergent coronary angiography revealed total thrombotic occlusion of the left anterior descending artery. Percutaneous coronary intervention with thrombectomy was successfully performed, and stenting was not required. The patient was discharged in stable condition after hospitalization for an additional 17 days.

DISCUSSION: This report highlights an atypical case of STEMI in a young patient without conventional atherosclerotic risk factors, presumably triggered by an IVIg infusion.

TAKE-HOME MESSAGE: Clinicians should be aware of the potential risk of thrombotic cardiac events associated with IVIg administration during the treatment of myasthenia gravis.