[Myocardial infarction and massive biventricular thrombosis during thrombocytopenia induced by pentosan polysulfate and heparin].
Many cases of immuno-allergic thrombocytopenia complicated by serious thromboembolism induced by heparin or other heparinoids such as pentosan polysulphate have been reported. This case is of interest for two reasons: first of all, it was induced by pentosan polysulphate and then reactivated by secondary administration of heparin; secondly, it was complicated successively by an infero-apical myocardial infarction with probable spontaneous lysis of a coronary thrombosis because coronary arteriography performed one month later was normal, and then by massive biventricular thrombosis requiring surgical thrombectomy under cardiopulmonary bypass. Tests of platelet aggregation were positive to standard heparin and to several low molecular weight fractions. The outcome was favorable when the responsible substances were withdrawn.
Service de cardiologie A, Hôtel-Dieu/CHR, Rennes.
C
C
Leclercq
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de Place
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C
Rioux
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P
Mabo
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F
Paillard
J C
JC
Daubert
D001780:Blood Coagulation Tests; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology*; D006352:Heart Ventricles / Q000503:physiopathology; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D010426:Pentosan Sulfuric Polyester / Q000009:adverse effects* / Q000627:therapeutic use; D010689:Phlebitis / Q000188:drug therapy; D010976:Platelet Count; D011134:Polysaccharides / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*
D011134:Polysaccharides; D010426:Pentosan Sulfuric Polyester; D006493:Heparin
Infarctus du myocarde et thrombose biventriculaire massive au cours d'une thrombopénie induite par le pentosane polysulfate et l'héparine.