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Acute myocardial infarction and extensive systemic thrombosis in thrombotic thrombocytopenic purpura: A case report and review of literature

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World Journal of Clinical Cases 2021年第27期9卷 8104-8113页

作者： Delia Lidia Salaru Cristina Andreea Adam dragos traian marius marcu Ionut Valentin Simon Liviu Macovei Lucian Ambrosie Elena Chirita Radu Andy Sascau Cristian Statescu Department of Cardiology Institute of Cardiovascular Diseases“Prof.Dr.George I.M.Georgescu”Iasi 700503Romania Internal Medicine University of Medicine and Pharmacy“Grigore T.Popa IașiRomania”Iasi 700115Romania General Surgery “Sf.Spiridon”Emergency Hospital IasiIasi 700111Romania

BACKGROUND Thrombotic thrombocytopenic purpura(TTP)is a thrombotic microangiopathy characterized by the pentad of hemolytic anemia,fever,thrombocytopenia,renal failure,and neurological *** formation of microthrombi in the arterioles and capillaries of various organs is one of the main pathophysiological *** manifestations of cardiac involvement in TTP patients are *** myocardial infarction has been reported as a complication with TTP as the secondary thrombotic *** emergence as the initial thrombotic event is extremely *** SUMMARY A 49-year-old previously healthy man was admitted for fever,typical angina chest pain 3 d prior to presentation,and newly onset left lower limb *** electrocardiogram illustrated ST-elevation acute myocardial infarction of the anterolateral wall of the left *** echocardiography depicted two large thrombi at the apex of the left ventricle and moderately reduced ejection fraction(40%).Venous Doppler ultrasound showed occlusion of the left popliteal *** tests showed severe thrombocytopenia,mild hemolytic anemia,elevated D-dimers,and high troponin and creatine *** computed tomography revealed other thrombotic sites(superior mesenteric artery,posterior aortic wall,spleen and renal infarction,and ileum necrosis).He was immediately started on steroids and addressed to surgery for acute abdominal *** an initial stabilization of the hematological deficit,he went into general surgery for resection of the necrotic ileum but died soon after the intervention due to multiple organ *** Cardiac involvement in TTP patients is common,challenging and more often fatal,especially when other thrombotic complications coexist.

关键词： Thrombotic thrombocytopenic purpura Acute myocardial infarction Limb ischemia Systemic thrombosis Review Case report

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