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Case Reports
. 2023 Mar 12;15(3):e36039.
doi: 10.7759/cureus.36039. eCollection 2023 Mar.

A Case of Thrombotic Thrombocytopenic Purpura and ST-Elevation Myocardial Infarction: An Unusual Correlation

Adekunle E Omole  1 , Azka Ali  2 , Kayode E Ogunniyi  3 , Danish Waqar  4 , Opeyemi Tobalesi  5 , Omar Rahim  6 , Ayoola Awosika  7   8
Affiliations
Case Reports

A Case of Thrombotic Thrombocytopenic Purpura and ST-Elevation Myocardial Infarction: An Unusual Correlation

Adekunle E Omole et al. Cureus. .

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare and potentially devastating blood disorder depicted by thrombocytopenia, fever, widespread small vessel hemolytic anemia, and neurological symptoms. The involvement of the renal and neurological systems is frequently reported in TTP; however, TTP-induced acute coronary syndrome is not widely reported. We describe a case of myocardial infarction induced by TTP in a patient who presented with the typical manifestation of acute coronary syndrome. Echocardiogram revealed a myocardial injury, and detailed investigations revealed increased levels of troponin I, lactate dehydrogenase, diminished levels of haptoglobin and von Willebrand factor-cleaving protease, and schistocytes on peripheral smear, suggestive of TTP-induced myocardial infarction. His condition was stabilized after commencing plasmapheresis, steroids, and rituximab. The initial steps in the management of this patient involve the prompt administration of steroids and the urgent start of plasmapheresis to increase platelet count.

Keywords: acquired ttp; acute coronary syndrome; acute thrombotic microangiopathy; myocardial infarction; thrombotic thrombocytopenic purpura; ttp.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Electrocardiograph demonstrating ST-segment elevation in leads 2, 3, and aVF with reciprocal changes in the aVL lead
aVF- Augmented vector Foot; aVL- Augmented vector Left
Figure 2
Figure 2. Trend of platelet count and serum creatinine during the hospital stay
See this image and copyright information in PMC

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