title: Ischemic Cardiomyopathy with a Rapid Progression from Thrombotic Thrombocytopenic Purpura.
abstract: An 83-year-old woman who complained of dizziness and nausea visited our hospital. An electrocardiogram showed ST-segment elevation in multiple leads and an echocardiogram showed severe hypokinesis of the anteroseptal wall of the left ventricle. However, emergency coronary angiography showed no stenotic lesions in any coronary arteries. A laboratory examination showed thrombocytopenia, renal dysfunction, and hemolysis. We therefore diagnosed the patient with thrombotic thrombocytopenic purpura (TTP). While we were preparing to initiate plasma exchange therapy, she suddenly developed cardiopulmonary arrest. A postmortem examination revealed microthrombi in the small vessels of the myocardium. We herein report a case of ischemic cardiomyopathy with a rapid progression from TTP.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University School of Medicine, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Morinaga
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tsutsui
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Atsutoshi
authors.initials: A
authors.lastname: Takagi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kajino
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000369:Aged, 80 and over; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017202:Myocardial Ischemia / Q000209:etiology*; D009206:Myocardium / Q000473:pathology; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy