Traditional pharmacological therapy for non-ST elevation acute myocardial infarction (AMI) relies on the use of anticoagulants or glycoprotein Ⅱb Ⅲa antagonists. However, in patients with systemic lupus erythematosus combined with life-threatening idiopathic thrombocytopenia and antiphospholipid syndrome will make the acute myocardial infarction treatment more difficult. We report a 39 year-old female with SLE who had acute myocardial infarction and profound thrombocytopenia. She survived after emergent intravenous immunoglobulin infusion and the intracoronary thrombus significantly disappeared after treatment with three months oral anticoagulants.