A Case of Acute Coronary Artery Occlusion Associated with Very Rapid Onset Heparin-induced Thrombosis without Thrombocytopenia

Abstract

An 81-year-old woman was admitted to our hospital with acute heart failure. A coronary stent was implanted in the left circumflex artery (LCX) on day 3, and elective percutaneous coronary intervention for stenosis in the left anterior descending artery (LAD) was planned for day 10. However, 15 minutes after heparin administration, sudden thrombotic occlusion occurred first in the LAD and then in the LCX. Although anti-platelet factor 4/heparin antibody positivity was detected, there was no significant decrease in platelet counts. This suggests that in the event of unexplained thrombosis, heparin-induced thrombosis should be suspected irrespective of platelet counts and early onset.