title: Cardiogenic shock due to thrombotic thrombocytopenic purpura.
abstract: We report the case of a 49-year-old man with thrombotic thrombocytopenic purpura (TTP) leading to cardiogenic shock. Laboratory data were typical for TTP with thrombocytopenia and microangiopathic hemolytic anemia. The electrocardiogram recorded significant ST-segment elevations in the anterior and inferior leads. In addition' coronary angiography showed normal epicardial coronary arteries with slow flow. The patient died due to electromechanical dissociation six hours after admission. During autopsy typical features of thrombotic thrombocytopenic purpura were found. Histological preparation of the heart showed a diffuse myocardial necrosis due to microvascular thrombosis. Cardiac involvement is common in TTP but extended myocardial necrosis has been reported in only a few cases.
authors.affiliation: HELIOS Klinikum Wuppertal, Universität Witten/Herdecke Kardiologie, Medizinische Klinik 3, Arrenberger Str. 20, 42117 Wuppertal, Germany. hlapp@wuppertal.helios-kliniken.de
authors.forename: H
authors.initials: H
authors.lastname: Lapp
authors.forename: D-I
authors.initials: DI
authors.lastname: Shin
authors.forename: W
authors.initials: W
authors.lastname: Kroells
authors.forename: G
authors.initials: G
authors.lastname: Boerrigter
authors.forename: M
authors.initials: M
authors.lastname: Horlitz
authors.forename: P
authors.initials: P
authors.lastname: Schley
authors.forename: S
authors.initials: S
authors.lastname: Stoerkel
authors.forename: H
authors.initials: H
authors.lastname: Guelker
mesh_terms: D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology