Sutherland Mark E, Haji Hassan, Borgan Saif M, Eimer Kelli M, Reed Robert M, McCurdy Michael T
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.
Respir Med Case Rep. 2019 Aug 13;28:100921. doi: 10.1016/j.rmcr.2019.100921. eCollection 2019.
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.
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.
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.
大量咯血是风湿性二尖瓣狭窄的一种罕见并发症。据我们所知，狭窄首次成功治疗后其复发情况尚未见报道。
我们描述了一名58岁的非裔美国女性，有因严重风湿性二尖瓣狭窄接受球囊瓣膜成形术的病史，因复发性二尖瓣狭窄出现大量危及生命的咯血而就诊于我院。再次球囊瓣膜成形术后出现严重二尖瓣反流并发症，患者因难治性心肺衰竭死亡，无法进行进一步干预。
危及生命的咯血是一种医疗急症，需要迅速确定出血源并治疗潜在病因。对于有危及生命的咯血且有风湿性心脏病危险因素的患者，无论既往手术治疗情况或单侧胸部X线体征如何，都应高度怀疑二尖瓣狭窄复发。
