Myocardial infarction following administration of oral contraceptive agents. 3 cases

The authors report the cases of three women aged 23, 24 and 28 years, receiving oestro-progestational agents and suffering a myocardial infarction. 25 cases in the literature are reviewed. Infarction is in most cases the first symptom. The clinical picture has no special features other than the frequency of anterior localisations. Coronary arteriography carried out in 15 cases showed a lesion of one vessel in 10 patients. The most common finding was a thrombosis of the left anterior descending. The coronaries were almost of completely normal in 3 cases, diffuse lesions being found only in 2 patients. The long term prognosis, at first sight favourable since the problem is one of localised lesions, is worsened by the frequency of ventricular contraction abnomalities. Myocardial infarction in patients taking oestro-progestational agents remains rare. A logical hypothesis to explain it would be a synergistic effect between the hypercoagulability induced by the drug and the risk factors in the individual patient. They are present with a frequency similar to that seen in other series of young patients with coronary disease.