# Type II Heparin-Induced Thrombocytopenia Manifesting As Cardiac Arrest Following Intravenous Heparin Bolus During an Elective Procedure: A Case Report and Literature Review

## TL;DR

A rare case of heparin-induced thrombocytopenia led to cardiac arrest after a heparin bolus during a routine heart procedure.

## Contribution

Reports a unique clinical case of type II HIT with severe complications following IV heparin use.

## Key findings

- Type II HIT presented with cardiac arrest after IV heparin bolus during an elective procedure.
- Patient developed thrombocytopenia, pulmonary hemorrhage, and cardiac arrest.
- Emphasizes the need for prompt clinical diagnosis and non-heparin anticoagulant use in such cases.

## Abstract

Heparin-induced thrombocytopenia (HIT) is a rare and life-threatening autoimmune-mediated adverse drug reaction seen in patients who are exposed to various forms of pharmacological heparin, including unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Despite the presence of thrombocytopenia, these patients face the risk of clot formation and bleeding simultaneously. Prompt cessation of heparin and the initiation of non-heparin anticoagulants are important for the patient's survival. Typically, clinical diagnosis of HIT is necessary, and waiting for lab test results, which can take days, may not be always feasible. Here, we present a case of an unusual presentation of type II HIT, complicated by significant thrombocytopenia, pulmonary hemorrhage, and cardiac arrest after receiving intravenous (IV) heparin bolus during an elective cardiac ablation procedure for paroxysmal atrial fibrillation.