4. Discussion
Illustrated in this report are hearts with hemorrhages and the patients had very low platelet counts (usually about 10,000 per uL), and hearts with calcified masses speculated to be the result of platelet thrombi in patients with thrombocytosis. Search of PubMed for cardiac consequences of thrombocytopenia or thrombocytosis yielded no publications. The present report of course has major limitations. We do not know what percent of patients with severe thrombocytopenia have hemorrhages in the heart. We suspect that the percent is exceedingly high. Most patients with cardiac hemorrhages associated with thrombocytopenia have no clinical consequences because of the extravasated erythrocytes. The exception might be the patients in whom the hemorrhages interrupted the cardiac conduction system at some point [1]. Whether the “rocks in the heart” were the consequences of thrombocytosis leading to thrombi which eventually calcified is of course an unproven scenario. That platelets were seen within the calcified mass in one of the three patients whose “rocks in the heart” was illustrated suggest that platelets did indeed play a role in producing the calcified masses.
