Published online Dec 26, 2018. doi: 10.4330/wjc.v10.i12.254
Peer-review started: August 28, 2018
First decision: October 16, 2018
Revised: November 20, 2018
Accepted: November 26, 2018
Article in press: November 26, 2018
Published online: December 26, 2018
Core tip: Thrombotic thrombocytopenic purpura (TTP) is a grave medical condition caused by the formation of von Willebrand factor multimers that cause large platelet plugs and diffuse microemboli, leading to life-threatening, multi-organ ischemic injuries. Although cardiac involvement commonly occurs related to TTP, these cardiac manifestations have not been well studied and may thus be overlooked in clinical practice. Management of cardiac ischemia or myocardial infarction in TTP is also challenging due to increased hemorrhagic risk in the setting of thrombocytopenia. In this report, we systematically review available clinical data in the literature and summarize clinical manifestation, diagnostic workup strategies, prognosis, and the outcomes of cardiac involvement of TTP. We provide recommendations on the strategies for clinical assessment and management of TTP patients with cardiac involvement.