Extensive coronary thrombosis in thrombotic–thrombocytopenic purpura

We describe a case of a 41-year-old female patient who was admitted with typical signs of thrombotic–thrombocytopenic purpura. Markers of myocardial ischemia (Troponin T, CK, CK-MB) were even present at admission without symptoms of angina pectoris. Only a few hours after admission the patient developed all signs of cardiogenic shock with subsequently cardiac arrest. Postmortal coronary angiographies showed occlusions in all coronary arteries with significant myocardial necrosis. We are unaware of any report that describes macrovascular occlusions in thrombotic–thrombocytopenic purpura.