Ridolfi R L, Hutchins G M, Bell W R
Ann Intern Med. 1979 Sep;91(3):357-63. doi: 10.7326/0003-4819-91-3-357.
The relation between the heart lesions of thrombotic thrombocytopenic purpura and clinical cardiac dysfunction was studied in 17 autopsied patients. Thirteen of the 17 patients had extensive small-vessel thromboses and in some instances hemorrhages and focal necroses within the heart. Congestive heart failure was present in nine of the 17 patients. Thrombotic microcirculatory cardiac lesions and anemia-related high cardiac output may have contributed to cardiac dysfunction. Serial histologic sections of the cardiac conducting system in 10 patients showed microthrombi in seven and associated hemorrhages in five. Lesions were localized to the atrioventricular node and His bundle parts of the system with sparing of the sinoatrial node and bundle branches. Two patients had electrocardiographic evidence suggesting lesions within conducting tissues. Thrombi and hemorrhages are common findings in the conducting tissues in thrombotic thrombocytopenic purpura and may account for cardiac arrest or transient rhythm disturbances.
对17例尸检患者的血栓性血小板减少性紫癜心脏病变与临床心脏功能障碍之间的关系进行了研究。17例患者中有13例存在广泛的小血管血栓形成，部分病例心脏内有出血和局灶性坏死。17例患者中有9例出现充血性心力衰竭。血栓性微循环心脏病变和贫血相关的高心输出量可能导致了心脏功能障碍。对10例患者心脏传导系统的连续组织学切片检查显示，7例有微血栓形成，5例伴有相关出血。病变局限于该系统的房室结和希氏束部分，窦房结和束支未受累。2例患者有心电图证据提示传导组织内有病变。血栓和出血是血栓性血小板减少性紫癜传导组织中的常见表现，可能是心脏骤停或短暂性心律失常的原因。
