Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
ASAIO J. 2013 May-Jun;59(3):322-3. doi: 10.1097/MAT.0b013e31828bbb00.
A 69-year-old man with advanced heart failure treated with a continuous-flow left ventricular assist device presented for evaluation of dark urine and severe dysphagia. Because of evidence of ongoing intravascular hemolysis with device dysfunction, there was a clinical suspicion for pump thrombosis. He had progressive end-organ dysfunction and was therefore treated with tissue plasminogen activator with prompt resolution in hemolysis and dysphagia. Although symptoms of smooth muscle dystonia could represent worsening heart failure in the setting of device failure, the observation may also be related to intravascular hemolysis as described in the prototypic hemolytic disease, paroxysmal nocturnal hemoglobinuria.
一位 69 岁的老年男性，患有晚期心力衰竭，接受了左心室辅助装置的连续血流治疗，因出现深色尿液和严重吞咽困难前来就诊。由于设备功能障碍导致持续的血管内溶血的证据，临床怀疑为泵血栓形成。他的终末器官功能逐渐恶化，因此接受了组织型纤溶酶原激活剂治疗，溶血和吞咽困难迅速缓解。尽管平滑肌张力障碍的症状可能代表在设备故障的情况下心力衰竭恶化，但这种观察也可能与血管内溶血有关，如阵发性夜间血红蛋白尿等典型溶血性疾病所述。
