Thotakura Sudhir, Costa Steven M, Cable Christian
Department of Internal Medicine (Thotakura, Cable) and the Division of Cardiology (Costa), Baylor Scott & White Health and Texas A&M Health Science Center College of Medicine, Temple, Texas.
Proc (Bayl Univ Med Cent). 2015 Oct;28(4):494-5. doi: 10.1080/08998280.2015.11929320.
Hemolytic anemia has been reported to occur in the setting of aortic stenosis and prosthetic heart valves, but much more rarely in association with obstructive hypertrophic cardiomyopathy (HC). Of the few descriptions of hemolytic anemia secondary to HC, all but one case involved bacterial endocarditis contributing to left ventricular outflow tract obstruction. We present the case of a 67-year-old man with recurrent hemolytic anemia and HC, without infective endocarditis. Attempts at iron repletion and augmentation of beta-blocker therapy proved his anemia to be refractory to medical management. Ventricular septal myectomy led to the resolution of hemolysis, anemia, and its coexisting symptoms.
据报道，溶血性贫血可发生于主动脉瓣狭窄和人工心脏瓣膜的情况下，但与梗阻性肥厚型心肌病（HC）相关的情况则更为罕见。在少数关于HC继发溶血性贫血的描述中，除一例之外，所有病例都涉及细菌性心内膜炎导致左心室流出道梗阻。我们报告一例67岁男性患者，患有复发性溶血性贫血和HC，但无感染性心内膜炎。补充铁剂和增加β受体阻滞剂治疗的尝试证明，他的贫血对药物治疗无效。室间隔肌切除术使溶血、贫血及其共存症状得到缓解。
