Thrombotic Thrombocytopenic Purpura (TTP) is a thrombotic microangiopathy 
syndrome resulting from decrease or absence of "a disintegrin and 
metalloproteinase with a thrombospondin type 1 motif member 13" (ADAMTS13). TTP 
has been characterized by the classical pentad of thrombocytopenia, hemolysis, 
fever, renal injury and neurological deficits, yet the patient may present with 
any atypical symptom related to microthrombi formation in the microcirculation. 
Here we present a rare case of a young patient with retrosternal chest pain and 
myocardial injury as the first manifestation of TTP.