Document Detail


Hemolytic anemia in a patient with hypertrophic obstructive cardiomyopathy.
MedLine Citation:
PMID:  20122559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 66-year-old woman was referred for further evaluation and treatment of normocytic and normochromic anemia with hemoglobin level of 8.6 g/dL. A peripheral blood smear showed fragmented erythrocytes. The patient was then referred to the department of cardiology because of systolic murmur, ECG abnormality, and red cell fragmentation. Transthoracic echocardiography revealed hypertrophic cardiomyopathy with particularly increased interventricular septal thickness of 24 mm and a hyperkinetic wall motion, resulting in marked obstruction to left ventricular outflow tract (pressure gradient of 200 mmHg). Mitral regurgitation due to systolic anterior motion of the mitral valve leaflets was also seen. The cause of anemia was thought to be mechanical intravascular hemolysis due to left ventricular outflow tract obstruction and mitral regurgitation. She was treated with atenolol and the class Ia antiarrhythmic drug cibenzoline to relieve the outflow tract obstruction, and the pressure gradient was reduced to 70 mmHg. After 3 months of treatment, her hemoglobin level had increased to 11.4 g/dL without additional treatment for anemia.
Authors:
Toru Kubo; Hiroaki Kitaoka; Yasunobu Terauchi; Shinjiro Tamura; Makoto Okawa; Naohito Yamasaki; Toshikazu Yabe; Yoshinori L Doi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-09
Journal Detail:
Title:  Journal of cardiology     Volume:  55     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  125-9     Citation Subset:  IM    
Copyright Information:
2009 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anemia, Hemolytic / etiology*
Anti-Arrhythmia Agents / therapeutic use
Atenolol / therapeutic use
Cardiomyopathy, Hypertrophic / complications*,  diagnosis
Echocardiography
Female
Humans
Imidazoles / therapeutic use
Mitral Valve Insufficiency / etiology
Ventricular Outflow Obstruction / etiology
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Imidazoles; 29122-68-7/Atenolol; 53267-01-9/cifenline

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