Refractory High Output Heart Failure in a Patient with Primary Mitochondrial Respiratory Chain Disease
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- Nakagawa Hitoshi
- First Department of Internal Medicine, Nara Medical University, Japan
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- Okayama Satoshi
- First Department of Internal Medicine, Nara Medical University, Japan
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- Kamon Daisuke
- First Department of Internal Medicine, Nara Medical University, Japan
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- Nakano Tomoya
- First Department of Internal Medicine, Nara Medical University, Japan
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- Onoue Kenji
- First Department of Internal Medicine, Nara Medical University, Japan
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- Kawakami Rika
- First Department of Internal Medicine, Nara Medical University, Japan
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- Horii Manabu
- First Department of Internal Medicine, Nara Medical University, Japan
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- Sakaguchi Yasuhiro
- First Department of Internal Medicine, Nara Medical University, Japan
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- Uemura Shiro
- First Department of Internal Medicine, Nara Medical University, Japan
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- Takemura Genzou
- Department of Cardiology, Gifu University Graduate School of Medicine, Japan
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- Saito Yoshihiko
- First Department of Internal Medicine, Nara Medical University, Japan
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抄録
A 40-year-old man who was referred to our hospital due to dyspnea was found to have high output cardiac failure on Swan-Ganz catheterization. An endomyocardial biopsy revealed cardiomyocyte hypertrophy with a vacuolar structure consistent with mitochondrial disease (MD). The patient was discharged, then readmitted for high output cardiac failure with hypotension and hyperlactacidemia. Treatment with cardiopulmonary support and hemodiafiltration gradually improved his general condition, although it resulted in ischemic necrosis of the right leg. The hyperlactacidemia completely resolved after amputation, and the high output cardiac failure has not recurred for two years. High output cardiac failure is rare in MD patients and is related to myocardial abnormalities and hyperlactacidemia.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 53 (4), 315-319, 2014
一般社団法人 日本内科学会