J Korean Med Sci.  2006 Apr;21(2):355-357. 10.3346/jkms.2006.21.2.355.

Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction with Idiopathic Thrombocytopenic Purpura: A Case Report

• Kim JH
• Park KU
• Chun WJ
• Kim SH
• Nah DY

• KMID: 1781850
• DOI: http://doi.org/10.3346/jkms.2006.21.2.355

Abstract

Acute myocardial infarction (AMI) is rare in patients with idiopathic thrombocytopenic purpura (ITP). We describe a case of an AMI during thrombocytopenia in a patient with chronic ITP. A 47-yr-old woman presented with anterior chest pain and a low platelet count (21,000/microliter) at admission. Urgent coronary angiography revealed total occlusion of proximal right coronary artery and primary percutaneous coronary intervention (PCI) was performed successfully. This case suggests that primary PCI may be a therapeutic option for an AMI in patients with ITP, even though the patient had severe thrombocytopenia.

Keyword

Myocardial Infarction; Percutaneous Coronary Intervention; Purpura; Thrombocytopenic; Idiopathic

MeSH Terms

Purpura, Thrombocytopenic, Idiopathic/*complications/drug therapy
Myocardial Infarction/*complications/*therapy
Middle Aged
Immunoglobulins, Intravenous/administration & dosage/adverse effects
Humans
Heparin/administration & dosage/adverse effects
Female
Anticoagulants/administration & dosage/adverse effects
*Angioplasty, Transluminal, Percutaneous Coronary

Figure

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  Fig. 1 Electrocardiogram shows the first degree atrioventricular block and ST segment elevation in leads of II, III, and aVF.

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  Fig. 2 Coronary angiography of the right coronary artery on left anterior oblique view. (A) Total obstruction in the proximal right coronary artery before percutaneous coronary intervention (PCI). (B) After the PCI with the aid of temporary pacemaker, successful reperfusion was obtained without residual stenosis.

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