Pathology of the Cardiac Conduction System in Thrombotic Thrombocytopenic Purpura

Abstract

Article1 July 1966Pathology of the Cardiac Conduction System in Thrombotic Thrombocytopenic PurpuraTHOMAS N. JAMES, M.D., F.A.C.P., RAYMOND W. MONTO, M.D., F.A.C.P.THOMAS N. JAMES, M.D., F.A.C.P.Search for more papers by this author, RAYMOND W. MONTO, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-1-37 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThrombotic thrombocytopenic purpura is a fascinating uncommon hematologic disease that is becoming recognized with increasing frequency. Among its classical manifestations are various neurologic symptoms such as dizziness, syncope, and convulsions (1-8). These symptoms have been reported and observed with and without neurologic sequelae. Since thrombotic thrombocytopenic purpura is a diffuse disease involving virtually every organ in the body, and since focal lesions in the conduction system of the heart could give rise to syncope and other symptoms easily interpreted as neurologic in origin, we have undertaken a study of the sinus node, atrioventricular node, and His bundle in three patients...References1. BAEHRKLEMPERERSCHIFRIN GPA: An acute febrile anemia and thrombocytopenic purpura with diffuse platelet thrombosis of capillaries and arterioles. Trans. Ass. Amer. Physicians 51: 43, 1936. Google Scholar2. GORE I: Disseminated arteriolar and capillary platelet thrombosis. Amer. J. Path. 26: 155, 1950. MedlineGoogle Scholar3. LEVINESHEARN SMA: Thrombotic thrombocytopenic purpura and systemic lupus ery thematosus. Arch. Intern. Med. (Chicago) 113: 826, 1964. CrossrefMedlineGoogle Scholar4. MEACHAMORBISONHEINLESTEELESCHAEFER GCJLRWHJJA: Thrombotic thrombocytopenic purpura. Blood 6: 706, 1951. CrossrefMedlineGoogle Scholar5. MOSCHOWITZ E: An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries. Arch. Intern. Med. (Chicago) 36: 89, 1925. CrossrefGoogle Scholar6. SINGER K: Thrombotic thrombocytopenic purpura. Advances Intern. Med. 6: 195, 1954. MedlineGoogle Scholar7. TALBOTTFERRANDIS JHRM: Collagen Diseases. Grune & Stratton, Inc., New York, 1956, pp. 181-191. Google Scholar8. WINTROBE MM: Clinical Hematology, 4th ed. Lea & Febiger, Philadelphia, 1956, pp. 837-838. Google Scholar9. JAMES TN: Anatomy of the human sinus node. Anat. Rec. 141: 109, 1961. CrossrefMedlineGoogle Scholar10. JAMES TN: Morphology of the human atrioventricular node, with remarks pertinent to its electrophysiology. Amer. Heart J. 62: 756, 1961. CrossrefMedlineGoogle Scholar11. JAMES TN: Anatomy of the Coronary Arteries. Paul B. Hoeber, Inc., New York, 1961. Google Scholar12. GENDELYOUNGKRAUS BRJMAP: Thrombotic thrombocytopenic purpura. Amer. J. Med. 13: 3, 1952. CrossrefMedlineGoogle Scholar13. ENGELSCHEINKERHUMPHREY GLIMDC: Acute febrile anemia and thrombocytopenic purpura with vasothromboses. Ann. Intern. Med. 26: 919, 1947. LinkGoogle Scholar14. FITZGERALDAUERBACHFRAME PJOE: Thrombocytic acroangiothrombosis. Blood 2: 519, 1947. CrossrefMedlineGoogle Scholar15. GITLOWGOLDMARK SC: Generalized capillary and arteriolar thrombosis; report of two cases with a discussion of the literature. Ann. Intern. Med. 13: 1046, 1939. LinkGoogle Scholar16. LASZLOALVAREZFELDMAN MHAF: The association of thrombotic thrombocytopenic purpura and disseminated lupus erythematosus: report of a case. Ann. Intern. Med. 42: 1308, 1955. LinkGoogle Scholar17. JAMESRUPEMONTO TNCERW: Pathology of the cardiac conduction system in systemic lupus erythematosus. Ann. Intern. Med. 63: 402, 1965. LinkGoogle Scholar18. JAMES TN: Pericarditis and the sinus node. Arch. Intern. Med. (Chicago) 110: 305, 1962. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Detroit, MichiganFrom the Department of Medicine, Henry Ford Hospital, Detroit, Mich.This study was supported in part by grants from the Michigan Heart Association and grants H-5197 and H-7108, the U. S. Public Health Service, Bethesda, Md.Requests for reprints should be addressed to Thomas N. James, M.D., Henry Ford Hospital, Detroit, Mich. 48202. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThrombotic Thrombocytopenic Purpura and Related Thrombotic MicroangiopathiesLink between von Willebrand factor multimers, relapses and coronary microcirculation in patients with thrombotic thrombocytopenic purpura in remissionCardiac implications of thrombotic thrombocytopenic purpuraThrombotic Thrombocytopenic Purpura, Hemolytic-Uremic Syndrome, and HELLPBackground and Presentation of Thrombotic Thrombocytopenic PurpuraAn autopsy case of myocardial infarction due to idiopathic thrombotic thrombocytopenic purpuraThrombotic Thrombocytopenia Purpura: A Potentially Reversible Cause of Complete Heart BlockCardiac Injury Is a Common Postmortem Finding in Thrombotic Thrombocytopenic Purpura Patients: Is Empiric Cardiac Monitoring and Protection Needed?Cardiac troponin-I on diagnosis predicts early death and refractoriness in acquired thrombotic thrombocytopenic purpura. Experience of the French Thrombotic Microangiopathies Reference CenterThrombotic microangiopathiesThrombotic Thrombocytopenic Purpura and Related Thrombotic MicroangiopathiesThrombotic Thrombocytopenic Purpura, Hemolytic-Uremic Syndrome, and HELLPCardiovascular Manifestations in Patients With Thrombotic Thrombocytopenic Purpura: A Single-center ExperienceCardiac involvement in acute thrombotic thrombocytopenic purpura: association with troponin T and IgG antibodies to ADAMTS 13Adenosine Triphosphate-sensitive Micro-reentrant Atrial Tachycardia Originating from the Crista Terminalis in a Patient with Chronic Renal Failure due to Thrombotic Thrombocytopenic PurpuraClinical cardiac involvement in thrombotic thrombocytopenic purpura: a systematic reviewThrombotic Thrombocytopenic PurpuraIncidence and prognosis of acute heart failure in the thrombotic microangiopathiesCurrent concepts in the diagnosis and management of thrombotic thrombocytopenic purpuraHomage to James B. Herrick: A Contemporary Look at Myocardial Infarction and at Sickle-Cell Heart DiseaseApoptosis in cardiac diseaseMassive Myocardial Necrosis in Thrombotic Thrombocytopenic PurpuraThrombotic Thrombocytopenic Purpura Causing Sudden, Unexpected Death—A Series of Eight PatientsMorphologic characteristics and functional significance of focal fibromuscular dysplasia of small coronary arteriesThe spectrum of diseases of small coronery arteries and their physiologic consequencesThrombotic MicroangiopathyThrombotic Thrombocytopenic Purpura in Older PatientsAnatomy and Pathology of Small Coronary ArteriesSir Thomas Lewis redivivus: from pebbles in a quiet pond to autonomic storms.Myocarditis and Cardiomyopathy: The Panoramic Nature of Their Etiology, Pathogenesis, and Clinical Consequences, with Special Consideration of the Involvement of the Conduction SystemAnatomie und pathologische Anatomie des spezifischen Reizbildungs- und Erregungsleitungssystems sowie des kontraktilen MyokardsChance and sudden deathNeural Pathology of the Heart in Sudden DeathThe Heart and Cardiac Conduction System in Thrombotic Thrombocytopenic Purpura A Clinicopathologic Study of 17 Autopsied PatientsREN L. RIDOLFI, M.D., GROVER M. HUTCHINS, M.D., WILLIAM R. BELL, M.D.Anatomy and Pathology of the Conduction System of the Human HeartDe subitaneis mortibus. XXVIII. Apoplexy of the heart.The sinus nodeSmall arteries of the heart.Therapy for Thrombotic Thrombocytopenic PurpuraCONRAD C. SIMPFENDORFER, M.D.De subitaneis mortibus. XIX. On the cause of sudden death in pheochromocytoma, with special reference to the pulmonary arteries, the cardiac conduction system, and the aggregation of platelets.De Subitaneis MortibusDe Subitaneis MortibusThe vasculature of the atrioventricular conduction system in heart blockCardiac conduction system: Fetal and postnatal developmentSudden death in babies: New observations in the heartPathology of small coronary arteriesThrombotic Thrombocytopenic Purpura Serial Clotting Studies, Relation to the Generalized Shwartzman Reaction, and Remission After Adrenal Steroid and Dextran TherapyROBERT G. LERNER, M.D., SAMUEL I. RAPAPORT, M.D., F.A.C.P., JAMES MELTZER, M.D. 1 July 1966Volume 65, Issue 1Page: 37-43KeywordsCardiovascular therapyConvulsionsHeart diseasesHospital medicineLesionsLongitudinal studiesMedical servicesSyncopeThrombotic thrombocytopenic purpura Issue Published: 1 July 1966 PDF downloadLoading ...