BACKGROUND Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy characterized by the pentad of hemolytic anemia, fever, thrombocytopenia, renal failure, and neurological dysfunction. The formation of microthrombi in the arterioles and capillaries of various organs is one of the main pathophysiological mechanisms. Clinical manifestations of cardiac involvement in TTP patients are variable. Acute myocardial infarction has been reported as a complication with TTP as the secondary thrombotic event. Its emergence as the initial thrombotic event is extremely rare. CASE 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 pain. The electrocardiogram illustrated ST-elevation acute myocardial infarction of the antero-lateral wall of the left ventricle. Transthoracic 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 artery. Laboratory tests showed severe thrombocytopenia, mild hemolytic anemia, elevated D-dimers, and high troponin and creatine kinase-MB. Abdominal 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 pain. After 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 failure. CONCLUSION Cardiac involvement in TTP patients is common, challenging and more often fatal, especially when other thrombotic complications coexist.

Мастер-класс ПРОБЛЕМЫ ОБУЧЕНИЯ НАВЫКАМ ОКАЗАНИЯ ПЕРВОЙ ПОМОЩИ РАЗЛИЧНЫХ СОЦИАЛЬНЫХ ГРУПП Автономная некоммерческая организация дополнительного профессионального образования «Учебно-консультационный центр аварийно-спасательных формирований им. В.В. Никулина», Новомосковск, Тульская обл., Россия Руководитель -Исраилова Татьяна Анатольевна Исраилова Т.А. ПРОБЛЕМЫ ОБУЧЕНИЯ НАВЫКАМ ОКАЗАНИЯ ПЕРВОЙ ПОМОЩИ РАЗЛИЧНЫХ СОЦИАЛЬНЫХ ГРУПП Israilova Tatyana A. ISSUES OF TRAINING FIRST AID PROVISION SKILLS TO VARIOUS SOCIAL GROUPS 4-10 июня June 4-10 СЕКЦИИ КОНГРЕССА TOPICS OF CONGRESS 1. Стрессы и неврозы: механизмы, профилактика и коррекция Stress and neurosis: mechanisms, prophylactic and correction Агаева С.В., Фараджев А.Н.

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