Double-territory STEMI with Cardiogenic shock in ITP with severe Thrombocytopenia – A Case Report

Abstract

Myocardial infarction in a patient with immune thrombocytopenia is a rare scenario which is very challenging to manage. We present a rare case of a patient with immune thrombocytopenic purpura who developed double territory ST-elevation myocardial infarction with cardiogenic shock. She had an extremely rare presentation with a fresh mobile thrombus in the aortic root which was trap-dooring the right coronary artery ostium and extending into the artery with embolism into the distal left anterior descending artery. We managed this patient conservatively with excellent recovery owing to the dangerous location of the hanging thrombus, and severe thrombocytopenia. Multidisciplinary approach is required for the management of myocardial infarction in patients with pre-existing blood disorders, with therapy tailored to the patient's presentation and treatment requirements.