The thrombotic microangiopathies, which include thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome, cause microangiopathic hemolytic anemia, thrombocytopenia, and ischemic events due to the presence of microvascular occlusive platelet thrombi.
1Associated mortality exceeded 90% before the introduction of plasma exchange therapy in the 1970s and still remains as high as 20%.
- Moake J.L.
N Engl J Med. 2002; 347: 589-600
2Based on our clinical experience, we hypothesized that high mortality may be partly due to development of heart failure. However, symptomatic cardiac involvement in patients with thrombotic microangiopathies is infrequently reported despite pathological studies demonstrating cardiac microthrombi.
- Elliott M.A.
- Nichols W.L.
Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome.
Mayo Clin Proc. 2001; 76: 1154-1162
- Berkowitz L.R.
- Dalldor F.G.
- Blatt P.
Thrombotic thrombocytopenic purpura a pathology review.
JAMA. 1979; 241: 1709-1710
- Cuttner J.
Thrombotic thrombocytopenic purpura a ten-year experience.
Blood. 1980; 56: 302-306
- Eagle K.A.
- Fallon J.T.
Weekly clinicopathological exercises: case 33-1994: A 41-year-old woman with thrombocytopenia, anemia, and sudden death.
N Engl J Med. 1994; 331: 661-667
- Ridolfi R.L.
- Hutchins G.M.
- Bell W.R.
The heart and cardiac conduction system in thrombotic thrombocytopenic purpura.
Ann Intern Med. 1979; 91: 357-363
7The aims of this study were to determine the incidence of acute heart failure in adults with thrombotic microangiopathies, its natural history, severity and reversibility of systolic dysfunction, and associated mortality rate.
- Ridolfi R.L.
- Bell W.R.
Thrombotic thrombocytopenic purpura report of 25 cases and review of the literature.
Medicine. 1981; 60: 413-428
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- Thrombotic microangiopathies.N Engl J Med. 2002; 347: 589-600
- Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome.Mayo Clin Proc. 2001; 76: 1154-1162
- Thrombotic thrombocytopenic purpura.JAMA. 1979; 241: 1709-1710
- Thrombotic thrombocytopenic purpura.Blood. 1980; 56: 302-306
- Weekly clinicopathological exercises: case 33-1994: A 41-year-old woman with thrombocytopenia, anemia, and sudden death.N Engl J Med. 1994; 331: 661-667
- The heart and cardiac conduction system in thrombotic thrombocytopenic purpura.Ann Intern Med. 1979; 91: 357-363
- Thrombotic thrombocytopenic purpura.Medicine. 1981; 60: 413-428
- The natural history of heart failure.N Engl J Med. 1971; 285: 1441-1446
- Myocarditis and myocardial hemorrhage associated with thrombotic thrombocytopenic purpura.Arch Intern Med. 1990; 150: 1535-1537
- Massive myocardial necrosis in thrombotic thrombocytopenic purpura.Arch Pathol Lab Med. 1999; 123: 937-940
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- Cardiovascular involvement in the hemolytic uremic syndrome.in: Kaplan B.S. Trompeter R.S. Moake J.L. Hemolytic Uremic Syndrome and Thrombotic Thrombocytopenic Purpura. Marcel Dekker, Inc, New York, New York1992: 143-149
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