Refractory High Output Heart Failure in a Patient with Primary Mitochondrial Respiratory Chain Disease

• Nakagawa Hitoshi

  First Department of Internal Medicine, Nara Medical University, Japan

• Okayama Satoshi

  First Department of Internal Medicine, Nara Medical University, Japan

• Kamon Daisuke

  First Department of Internal Medicine, Nara Medical University, Japan

• Nakano Tomoya

  First Department of Internal Medicine, Nara Medical University, Japan

• Onoue Kenji

  First Department of Internal Medicine, Nara Medical University, Japan

• Kawakami Rika

  First Department of Internal Medicine, Nara Medical University, Japan

• Horii Manabu

  First Department of Internal Medicine, Nara Medical University, Japan

• Sakaguchi Yasuhiro

  First Department of Internal Medicine, Nara Medical University, Japan

• Uemura Shiro

  First Department of Internal Medicine, Nara Medical University, Japan

• Takemura Genzou

  Department of Cardiology, Gifu University Graduate School of Medicine, Japan

• Saito Yoshihiko

  First Department of Internal Medicine, Nara Medical University, Japan

Abstract

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>

Journal

• Internal Medicine

  Internal Medicine 53 (4), 315-319, 2014

  The Japanese Society of Internal Medicine

Keywords

• high output heart failure
• mitochondrial cardiomyopathy
• mitochondrial disease
• MELAS
• lactate
• hemodiafiltration

Details

• CRID: 1390282679847201920
• NII Article ID: 130003392649
• DOI: 10.2169/internalmedicine.53.1386
• COI: 1:STN:280:DC%2BC2cvlsFOksA%3D%3D
• ISSN: 13497235
• ISSN: 09182918
• PubMed: 24531087
• Web Site: https://www.jstage.jst.go.jp/article/internalmedicine/53/4/53_53.1386/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2014376518
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed