[Thrombotic thrombocytopenic purpura: do not ignore cardiac involvement]

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.

Keywords: Arrêt cardiaque; Cardiac arrest; Cœur; Heart; Purpura thrombotique thrombocytopénique; Thrombotic thrombocytopenic purpura; Troponin; Troponine.