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  • Title: [Thrombotic thrombocytopenic purpura: do not ignore cardiac involvement].
    Author: Puyade M, Badin J, Quéron B, Christiaens L, Varroud-Vial N, Pierre F, Pourrat O.
    Journal: Rev Med Interne; 2014 Apr; 35(4):264-7. PubMed ID: 23711951.
    Abstract:
    INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy due to ADAMTS13 deficiency (a von Willebrand factor's metalloprotease) with multiple organs' involvement, one of which may be the heart. CASE REPORT: We report a 29-year-old woman who presented a TTP during her last trimester of pregnancy, under the features of a HELLP syndrome. After caesarean section, cardiac involvement was revealed by chest pain, ECG changes, antero-septal hypokinesia and troponin rise. Cardiac MRI found no large-vessel ischemic heart disease and confirmed hypokinesia. CONCLUSION: When TTP is diagnosed, cardiac involvement must be systematically investigated by ECG and troponin assay because of the risk of a cardiac arrest.
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