Document Detail

Primary percutaneous transluminal coronary angioplasty performed for acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura.
MedLine Citation:
PMID:  10084377     Owner:  NLM     Status:  MEDLINE    
A 72-year-old female with idiopathic thrombocytopenic purpura (ITP) complained of severe chest pain. Electrocardiography showed ST-segment depression and negative T wave in I, aVL and V4-6. Following a diagnosis of acute myocardial infarction (AMI), urgent coronary angiography revealed 99% organic stenosis with delayed flow in the proximal segment and 50% in the middle segment of the left anterior descending artery (LAD). Subsequently, percutaneous transluminal coronary angioplasty (PTCA) for the stenosis in the proximal LAD was performed. In the coronary care unit, her blood pressure dropped. Hematomas around the puncture sites were observed and the platelet count was 28,000/mm3. After transfusion, electrocardiography revealed ST-segment elevation in I, aVL and V1-6. Urgent recatheterization disclosed total occlusion in the middle segment of the LAD. Subsequently, PTCA was performed successfully. Then, intravenous immunoglobulin increased the platelet count and the bleeding tendency disappeared. A case of AMI with ITP is rare. The present case suggests that primary PTCA can be a useful therapeutic strategy, but careful attention must be paid to hemostasis and to managing the platelet count.
T Fuchi; T Kondo; K Sase; M Takahashi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  63     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-05-24     Completed Date:  1999-05-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  133-6     Citation Subset:  IM    
Division of Cardiology, Shimabara Hospital, Kyoto, Japan.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Blood Transfusion
Coronary Angiography
Coronary Disease / complications,  therapy
Hematoma / etiology
Hemostatic Techniques
Hypotension / etiology
Immunoglobulins, Intravenous / therapeutic use
Myocardial Infarction / complications,  radiography,  therapy*
Platelet Aggregation Inhibitors / therapeutic use
Platelet Count
Punctures / adverse effects
Purpura, Thrombocytopenic, Idiopathic / complications*,  therapy
Reg. No./Substance:
0/Immunoglobulins, Intravenous; 0/Platelet Aggregation Inhibitors

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