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抗磷脂抗体综合征患者因慢性肾动脉近端主动脉闭塞导致的急性心力衰竭。

Acute heart failure due to chronic juxtarenal aortic occlusion in a patient with antiphospholipid antibody syndrome.

作者信息

Yoshihara Tsutomu, Hasebe Hideyuki, Shimasaki Megumi, Uyama Satoko, Takanohashi Seiko, Togawa Akashi, Takanohashi Akira, Shirota Kazuaki, Nakamura Hajime

机构信息

Division of Arrhythmology and Cardiology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.

Division of Nephrology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.

出版信息

J Cardiol Cases. 2014 Jun 19;10(2):69-72. doi: 10.1016/j.jccase.2014.05.004. eCollection 2014 Aug.

Abstract

Abdominal aortic occlusions are rare, but occasionally life threatening. A 48-year-old man was hospitalized due to acute heart failure accompanied by acute kidney injury (AKI). Abdominal ultrasound revealed deteriorating blood flow in the bilateral renal arteries. Subsequent abdominal aortography showed abdominal aortic occlusion just below the right renal artery and an occluded left renal artery. Dilated superior and inferior mesenteric arteries functioning as collateral feeding arteries suggested chronic occlusion. A hypercoagulation workup led to a diagnosis of antiphospholipid antibody syndrome (APS). This case report describes rare chronic juxtarenal abdominal occlusion in a patient with APS. < Abdominal aortic occlusions are rare, but occasionally life threatening. The proximal propagation of aortic thrombosis might cause prerenal AKI. In our case, the renal arteries' involvement of chronic juxtarenal arteries in a patient with APS gave rise to the onset of acute heart failure associated with prerenal AKI.>.

摘要

腹主动脉闭塞较为罕见,但偶尔会危及生命。一名48岁男性因急性心力衰竭伴急性肾损伤(AKI)入院。腹部超声显示双侧肾动脉血流恶化。随后的腹主动脉造影显示右肾动脉下方腹主动脉闭塞,左肾动脉闭塞。扩张的肠系膜上动脉和肠系膜下动脉作为侧支供血动脉提示慢性闭塞。一项高凝检查导致抗磷脂抗体综合征(APS)的诊断。本病例报告描述了APS患者罕见的慢性肾旁腹主动脉闭塞。<腹主动脉闭塞较为罕见,但偶尔会危及生命。主动脉血栓形成的近端蔓延可能导致肾前性AKI。在我们的病例中,APS患者慢性肾旁动脉的肾动脉受累导致了与肾前性AKI相关的急性心力衰竭的发作。>

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Renovascular hypertension: screening and modern management.肾血管性高血压:筛查与现代管理。
Eur Heart J. 2011 Jul;32(13):1590-8. doi: 10.1093/eurheartj/ehq510. Epub 2011 Jan 27.

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