风湿性二尖瓣狭窄行二尖瓣成形术后出现危及生命的咯血。

Life-threatening hemoptysis following mitral valvuloplasty for rheumatic mitral stenosis.

作者信息

Sutherland Mark E, Haji Hassan, Borgan Saif M, Eimer Kelli M, Reed Robert M, McCurdy Michael T

机构信息

Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.

Division of Pulmonary and Critical Care Medicine, Sinai Hospital of Baltimore, Baltimore, MD, United States.

出版信息

Respir Med Case Rep. 2019 Aug 13;28:100921. doi: 10.1016/j.rmcr.2019.100921. eCollection 2019.

DOI:10.1016/j.rmcr.2019.100921

PMID:31453083

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6704374/

Abstract

BACKGROUND

Massive hemoptysis is a rare complication of rheumatic mitral valve stenosis. Its recurrence following successful initial treatment of the stenosis has not, to our knowledge, been described.

CASE REPORT

We describe a 58-year-old African American woman with a history of balloon valvuloplasty for the treatment of severe rheumatic mitral valve stenosis who presented to our institution with massive life-threatening hemoptysis due to recurrent mitral valve stenosis. Repeat balloon valvuloplasty was complicated postoperatively by severe mitral regurgitation and the patient expired from refractory cardiopulmonary collapse not amenable to further intervention.

CONCLUSION

Life-threatening hemoptysis is a medical emergency requiring rapid source identification and treatment of the underlying etiology. A high degree of suspicion should be maintained for recurrence of mitral valve stenosis in patients presenting with life-threatening hemoptysis and risk factors of rheumatic heart disease, regardless of previous surgical management or unilateral chest x-ray signs.

摘要