Case reports in cardiology · 2026
Explosive Multiterritorial Arterial Thrombosis Following Brief Heparin Exposure: A Diagnostic Pitfall in the Cath Lab.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Massart Justine, Ungureanu Claudiu, Dascotte Yves, Auslender Jacques, Jossart Adrien
Аннотация
BACKGROUND: Type II heparin-induced thrombocytopenia (HIT) is a catastrophic immunothrombotic disorder that can be triggered by minimal heparin exposure during routine coronary angiography.
CASE SUMMARY: A 67-year-old woman developed "explosive" multiterritorial arterial thrombosis-including acute limb ischemia, an inferior STEMI, and a stroke-within minutes of receiving 5000 units of intra-arterial heparin. This followed a brief nadroparin exposure 8 days prior. Crucially, events occurred while platelet counts were still normal. Despite a negative functional assay, a high 4T score (6 points) confirmed HIT. Management involved non-heparin anticoagulation (danaparoid sodium) and thrombectomies.
DISCUSSION: This case highlights a major diagnostic pitfall: severe arterial thrombosis preceding overt thrombocytopenia. The immediate "anaphylactoid-like" reaction following a heparin bolus is often misidentified as contrast allergy, delaying life-saving intervention.
TAKE HOME MESSAGES: Suspect HIT in acute systemic reactions or multifocal thrombosis after heparin exposure, regardless of initial platelet counts.
CASE SUMMARY: A 67-year-old woman developed "explosive" multiterritorial arterial thrombosis-including acute limb ischemia, an inferior STEMI, and a stroke-within minutes of receiving 5000 units of intra-arterial heparin. This followed a brief nadroparin exposure 8 days prior. Crucially, events occurred while platelet counts were still normal. Despite a negative functional assay, a high 4T score (6 points) confirmed HIT. Management involved non-heparin anticoagulation (danaparoid sodium) and thrombectomies.
DISCUSSION: This case highlights a major diagnostic pitfall: severe arterial thrombosis preceding overt thrombocytopenia. The immediate "anaphylactoid-like" reaction following a heparin bolus is often misidentified as contrast allergy, delaying life-saving intervention.
TAKE HOME MESSAGES: Suspect HIT in acute systemic reactions or multifocal thrombosis after heparin exposure, regardless of initial platelet counts.