Non-ST-Segment Elevation Myocardial Infarction As Initial Thrombotic Event of Thrombotic Thrombocytopenic Purpura: A Rare Challenging Case

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare autoimmune and devastating blood disorder that results in micro-clots throughout the body, leading to tissue damage and organ dysfunction resulting in widespread microangiopathic hemolytic anemia, thrombocytopenia, fever, and neurological symptoms. TTP patients commonly manifest renal and neurological symptoms; however, cardiovascular involvement is not widely reported in the literature. We report a case of non-ST-segment elevation myocardial infarction (NSTEMI) as an initial manifestation of TTP. Although rare, TTP complications must be considered among other possible causes of unexpected thrombocytopenia during acute phase treatment of acute coronary syndrome because of high morbidity and mortality.

Acute myocardial infarction in a patient with thrombotic thrombocytopenic purpura: a case report and literature review

“…AMI has been associated with TTP, with reported incidence rate varying between 15% and 41% [6,8] . Reported cases of AMI induced by TTP [4,[9][10][11][12][13][14][15][16][17][18][19][20] are summarized in Table 3. A large national database of 4,032 patients with TTP [21] reported 11.1% in-hospital mortality and 5.7% AMI rate.…”