Fig. 5.

Evolution of platelet count. The platelet count decreased after each administration of heparin for emergent PCI or follow-up coronary angiography. However, the fall in platelet count was not recognized until the 3rd hospitalization for ACS as the baseline platelet count was high and the lowest count during each admission remained within normal limits. The patient received iron intravenously nearly every month for 3 years for profuse menstrual bleeding, which might have activated circulating HIT antibodies. This patient received 10,000 IU of total unfractionated heparin during PCI on the third ACS, higher than during previous angiographies or PCI (1,500–6,000 IU). ACS = acute coronary syndrome; CA = coronary angiography; UFH = unfractionated heparin; Plt = platelet