書誌事項
- タイトル別名
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- Puerperal Secondary Pulmonary Hypertension in a Patient with Mixed Connective Tissue Disease.
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A woman with mixed connective tissue disease (MCTD) developed pulmonary hypertension after delivery of a child, but had little evidence of parenchymal lung disease. This 29-year-old woman had been given a diagnosis of MCTD when she was 19 years old. She was admitted to our department two days after delivery of a child, because of dyspnea on exertion. Acute thromboembolism was suspected because of: (1) chest roentgenogram showing cardiomegaly and enlargement of the left main pulmonary artery, (2) a lung perfusion scan showing a segmental defect in the left S6 and S8 areas, (3) laboratory studies showing abnormally high WBC, LDH, FDP, and D-D dimer, and (4) arterial blood gas analyses showing mild hypoxemia and hypocapnia. Thrombolytic therapy with heparin and urokinase was begun, and was followed by a loop diuretic and anticoagulation with warfarin. One month after admission, cardiac enlargement and the A-aDO2 were found to have decreased. At that time, cardiac catheterization was done and revealed pulmonary hypertension (mean PA pressure: 45mmHg)and low cardiac output with no detectable thrombosis in the left pulmonary artery. The patient was subsequently treated with a calcium antagonist and a prostacyclin derivative, and her condition was stable for 5 months. Then her exercise tolerance gradually decreased due to shortness of breath, and cardiomegaly gradually increased over the next 3 months. Eight months after delivery of the child, the patient died of right heart failure. In clinically stable patients with MCTD, delivery of a child may lead to pulmonary thromboembolism and pulmonary hypertension.
収録刊行物
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- 日本胸部疾患学会雑誌
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日本胸部疾患学会雑誌 33 (8), 883-887, 1995
社団法人 日本呼吸器学会
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詳細情報 詳細情報について
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- CRID
- 1390001205017974144
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- NII論文ID
- 10007865006
- 130003678853
- 10008107807
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- NII書誌ID
- AN00187758
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- ISSN
- 1883471X
- 03011542
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- PubMed
- 7474571
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- PubMed
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可