Contrast-induced thrombocytopenia is a rare complication distinguished by acute and severe platelet consumption, with spontaneous recovery within days. We describe a case of acute thrombocytopenia 6 hours after coronary angioplasty in a patient with a negative antiplatelet factor 4 test. The count reached 1 × 10/µL, but improved spontaneously to 210 × 10/µL after 8 days. In conclusion, physicians should be aware of this complication, particularly when dual antiplatelet therapy is being considered.
Thirteen years after her last thrombotic event, anticoagulation was discontinued in a patient with combined thrombophilia involving mutation in factor V and G20210A polymorphism of the prothrombin gene. The only history was of arterial thrombosis. Three months later she presented a transmural myocardial infarction caused by coronary thrombosis.
Um longo espectro de manifestações clínicas da cardiopatia isquêmica se situa entre a síndrome coronariana bem definida da angina do peito estável e o infarto agudo do miocárdio (IAM) do outro. Essas manifestações foram integradas no grupo da cardiopatia coronariana aguda e, incluem uma grande variedade de quadros clínicos de gravidade diversa, mas que implicam sempre, independentemente de sua forma de exteriorização clínica, na possibilidade de morte súbita, bem como no risco de evoluir para um infarto reconhecível ou de se estender para um infarto de maior gravidade.
Takotsubo syndrome, which has been recently described by Japanese authors, is characterized by a reversible abnormality of the ventricular wall movement, with a morphological aspect similar to a balloon, or more precisely, from a semantic point of view, to an amphora-like octopus trap, at the apical segment levels of the heart and hypercontraction of the basal segments observed during the coronary arteriography with ventriculography, associated with electrocardiographic ST-T segment alterations, similar to an acute myocardial infarction episode, with minimal elevation of cardiac enzymes, affecting preferentially elderly females and being induced by physical or emotional stress 1 . The diagnosis of this entity is reinforced by the almost complete absence of coronary circulation morphostructural alterations. Another aspect that is noteworthy is the rapid duration of the asynergy of the ventricular wall movement, eventually contrasting with the longer duration of the clinical manifestations. The etiology of the disease is not fully known, and the role of coronary microcirculation involvement at a multivascular level (severe expression of microvascular angina), and, more recently, the possibility of the participation of altered adrenergic catecholamine dynamics at myocardial level has been hypothesized 2,3 . The exceptional circumstances of the case reported here are due to the simultaneous presence of two conditions that are potentially harmful to the heart, i.e., systemic lupus erythematosus and morbid obesity, associated with this unusual form of cardiomyopathy induced by acute stress. Pericardial and endocardial alterations, vasculitis of the coronary circulation as well as congenital heart block in neonatal lupus briefly constitute the classical cardiac alterations of this auto-immune disease. The impact of morbid obesity on the cardiovascular system is basically caused by the effect of systemic arterial hypertension, dyslipidemia, diabetes and hypoxemic pulmonary arterial hypertension, being broadly known aspects of the disease in the specialized literature.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.