Heparin-induced thrombocytopenia due to low-molecular weight heparin in female patient after aortic valve replacement with a mechanical prosthesis

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Resumo

Heparin-induced thrombocytopenia (HIT) is a serious and potentially life-threatening complication of heparin therapy. In patients who received unfractionated heparin as anticoagulant therapy for ≥ 4 days, the incidence of HIT varies from 0.2 to 5%. Although the risk of HIT developing with low molecular weight heparin (LMWH) injection is 10 times lower, such cases still occur in clinical practice. Due to insufficient awareness of physicians about such complication of heparin therapy and the lack of necessary laboratory tests, the diagnosis of HIT is often delayed. The article presents a clinical case of HIT during LMWH therapy in a 65-year-old female patient after mechanical aortic valve replacement under artificial blood circulation, complicated by arterial and venous thromboses, including hemodynamically significant pulmonary embolism, which required thrombolytic therapy, as well as occlusive thrombosis of the femoral-popliteal-tibial segment of the arteries of the right lower limb, which necessitated surgical recanalization.

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Sobre autores

Zoya Tatarintseva

Professor S.V. Ochapovsky Research Institute – Regional Clinical Hospital No. 1; Kuban State Medical University of the Ministry of Healthcare of Russia

Autor responsável pela correspondência
Email: z.tatarintseva@list.ru
ORCID ID: 0000-0002-3868-8061
Código SPIN: 9613-3479

MD, PhD (Medicone), head of the Department of cardiology, assistant at the Department of cardiac surgery and cardiology of the Faculty of advanced training and professional retraining of specialists

Rússia, 350086, Krasnodar, 167 Pervogo Maya St.; 350063, Krasnodar, 4 Mitrofana Sedina St.

Arina Palshkova

Kuban State Medical University of the Ministry of Healthcare of Russia

Email: arinapalshkova11@mail.ru
ORCID ID: 0009-0007-7949-649X

resident of the Department of cardiac surgery and cardiology of the Faculty of advanced training and professional retraining of specialists

Rússia, 350063, Krasnodar, 4 Mitrofana Sedina St.

Maria Sinelnikova

Kuban State Medical University of the Ministry of Healthcare of Russia

Email: missosin@yandex.ru
ORCID ID: 0009-0004-6277-1502

resident of the Department of cardiac surgery and cardiology of the Faculty of advanced training and professional retraining of specialists

Rússia, 350063, Krasnodar, 4 Mitrofana Sedina St.

Elena Kosmacheva

Professor S.V. Ochapovsky Research Institute – Regional Clinical Hospital No. 1

Email: kosmachova_h@mail.ru
ORCID ID: 0000-0001-5690-2482

MD, Dr. Sci. (Medicine), professor, deputy chief physician for medical affairs

Rússia, 350086, Krasnodar, 167 Pervogo Maya St.

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2. Fig. 1. Computed tomography of the chest organs with contrast of the observed patient

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3. Fig. 2. Computed tomography of the chest organs with contrast of the observed patient on the 22nd day of hospitalization

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4. Fig. 3. Computed tomography of the abdominal organs with contrast of the observed patient on the 22nd day of hospitalization

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5. Fig. 4. Dependence of platelet counts in the observed patient on antiplatelet therapy and time elapsed since the day of surgery

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6. Fig. 5. Computed tomography of the abdominal aorta and arteries of the lower extremities of the observed patient

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