Postpartum coronary artery dissection complicated by heparin-induced thrombocytopenia and thrombosis.
A 32-year-old woman presented with an acute anterior-lateral myocardial infarction 7 days postpartum. Coronary angiography revealed an occlusive left main coronary artery dissection. After coronary artery bypass surgery the patient's cardiac function improved and stabilized. Thrombocytopenia and a femoral artery thrombosis after 9 days of heparin exposure marked the development of heparin-induced thrombocytopenia and thrombosis that was successfully managed with argatroban, a direct thrombin inhibitor anticoagulant.
Eby
C S
CS
Department of Pathology, Saint Louis University School of Medicine, Missouri, USA. eby@labmed.wustl.edu
McBride
L R
LR
D000328:Adult; D000784:Aortic Dissection / Q000150:complications*; D000925:Anticoagulants / Q000009:adverse effects*; D003327:Coronary Disease / Q000150:complications*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D011644:Puerperal Disorders / Q000139:chemically induced*; D013921:Thrombocytopenia / Q000139:chemically induced*; D013927:Thrombosis / Q000139:chemically induced*
D000925:Anticoagulants; D006493:Heparin