Iroulart Juan María, Ferrero Joaquín, Blanco Rocío, Licht Roshan, Miceli Ana, Pellegrini María Natalia, Pérez de Arenaza Diego, Pizarro Rodolfo
Servicio de Cardiología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina. Servicio de Cardiología Hospital Italiano de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina.
Arch Peru Cardiol Cir Cardiovasc. 2025 Feb 12;6(1):49-53. doi: 10.47487/apcyccv.v6i1.440. eCollection 2025 Jan-Mar.
We present the case of a 42-year-old male patient with a history of bilateral lung transplantation and chronic graft dysfunction. The patient presented to the adult emergency department due to acute heart failure. During his stay in the emergency room and in outpatient follow-up, cardiac multi-imaging led to the diagnosis of double-chambered right ventricle with associated hypertrophic cardiomyopathy. Given the presence of advanced lung disease and poor adherence to immunosuppressant medication as well as clinical follow-ups, the patient was deemed unsuitable for re-lung transplantation. The optimization of his immunosuppressive medication was prioritized, and beta-blockers were added as part of the treatment for dynamic right ventricular outflow obstruction. He was referred to pulmonary rehabilitation, currently showing a partially favorable evolution to functional class II.
我们报告了一例42岁男性患者，有双侧肺移植及慢性移植物功能障碍病史。该患者因急性心力衰竭就诊于成人急诊科。在其留院急诊期间及门诊随访过程中，心脏多模态成像检查诊断为双腔右心室合并肥厚型心肌病。鉴于患者存在晚期肺部疾病、免疫抑制药物依从性差以及临床随访情况，认为其不适合再次进行肺移植。优先优化其免疫抑制药物治疗方案，并加用β受体阻滞剂作为治疗动态右心室流出道梗阻的一部分。他被转诊至肺康复治疗，目前功能分级部分改善至Ⅱ级。
