title: Heparin-induced thrombocytopenia (HIT) causing pulmonary emboli during coronary intervention.
abstract: Thrombotic complications of heparin-induced thrombocytopenia (HIT) can be devastating if not recognized and treated promptly. We describe an unusual case of rapid-onset HIT resulting in massive-bilateral pulmonary emboli in a 70 year-old man who developed chest pain during elective percutaneous coronary intervention (PCI). The diagnosis was made the following day after persistent chest pain and laboratory work demonstrating a new thrombocytopenia, a mildly elevated troponin, and positive DIC panel led to confirmatory imaging tests. HIT-related thrombosis should be considered in the differential diagnosis of chest pain in patients undergoing PCI.
authors.affiliation: Cardiology Division, University of Utah, Salt Lake City, Utah 84132-2401, USA.
authors.forename: Ronny S
authors.initials: RS
authors.lastname: Jiji
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Michaels
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000139:chemically induced; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000009:adverse effects*; D001120:Arginine / Q000031:analogs & derivatives; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced; D017128:Embolectomy; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010875:Pipecolic Acids / Q000627:therapeutic use; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016306:Vena Cava Filters
chemical_list: D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban